Ehrlichiosis medical therapy: Difference between revisions
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{{Ehrlichiosis}} | {{Ehrlichiosis}} | ||
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==Medical Therapy== | |||
* [[Doxycycline]] is the drug of choice. | |||
* For people allergic to drugs of the [[tetracycline]] class, [[rifampicin]] is an alternative.<ref name="Goddard"/> | |||
* Early clinical experience suggested that [[chloramphenicol]] may also be effective, however in vitro susceptibility testing revealed [[resistance]]. | |||
===Antimicrobial regimen=== | |||
*1. '''[[Ehrlichiosis|Human Monocytic Ehrlichiosis]] or [[Human Granulocytic Anaplasmosis]] (adult)''' <ref name=CDC centers for the disease control and prevention>{{cite web | title =Ehrlichiosis CDC centers for the disease control and prevention| url= http://www.cdc.gov/ehrlichiosis/symptoms/index.html#treatment }}</ref> <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | |||
:* Preferred regimen: [[Doxycycline]] 100 mg PO/IV q12h for 7-14 days | |||
:* Note: Patients should be treated for at least 3 days after the fever subsides and until there is evidence of clinical improvement | |||
:* Alternative regimen (1): [[Chloramphenicol]] 500mg PO qid | |||
:* Alternative regimen (2): [[Rifampin]] 600 mg PO/IV qd for 7-10 days | |||
*2. '''[[Ehrlichiosis|Human Monocytic Ehrlichiosis]] or [[Human Granulocytic Anaplasmosis]] (pediatric)''' | |||
:*2.1 '''≥ 8 years old''' | |||
::* Preferred regimen: [[Doxycycline]] 2 mg/kg IV/PO q12h (Maximum, 200 mg/day) for 10 days | |||
:*2.2 '''< 8 years old without Lyme disease''' | |||
::* Preferred regimen: [[Doxycycline]] 2 mg/kg IV/PO q12h (Maximum, 200 mg/day) for 4-5 days (or 3 days after resolution of fever) | |||
:*2.3 '''co-infected with Lyme disease''' | |||
::* Preferred regimen: [[Doxycycline]], then [[Amoxicillin]] 50 mg/kg in 3 divided doses (Maximum, 500 mg/dose) {{or}} [[Cefuroxime]] 30 mg/kg in 2 divided doses (Maximum, 500 mg/dose) for 14 days | |||
==References== | ==References== |
Revision as of 17:08, 6 August 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Medical Therapy
- Doxycycline is the drug of choice.
- For people allergic to drugs of the tetracycline class, rifampicin is an alternative.[1]
- Early clinical experience suggested that chloramphenicol may also be effective, however in vitro susceptibility testing revealed resistance.
Antimicrobial regimen
- 1. Human Monocytic Ehrlichiosis or Human Granulocytic Anaplasmosis (adult) [2]
- Preferred regimen: Doxycycline 100 mg PO/IV q12h for 7-14 days
- Note: Patients should be treated for at least 3 days after the fever subsides and until there is evidence of clinical improvement
- Alternative regimen (1): Chloramphenicol 500mg PO qid
- Alternative regimen (2): Rifampin 600 mg PO/IV qd for 7-10 days
- 2. Human Monocytic Ehrlichiosis or Human Granulocytic Anaplasmosis (pediatric)
- 2.1 ≥ 8 years old
- Preferred regimen: Doxycycline 2 mg/kg IV/PO q12h (Maximum, 200 mg/day) for 10 days
- 2.2 < 8 years old without Lyme disease
- Preferred regimen: Doxycycline 2 mg/kg IV/PO q12h (Maximum, 200 mg/day) for 4-5 days (or 3 days after resolution of fever)
- 2.3 co-infected with Lyme disease
- Preferred regimen: Doxycycline, then Amoxicillin 50 mg/kg in 3 divided doses (Maximum, 500 mg/dose) OR Cefuroxime 30 mg/kg in 2 divided doses (Maximum, 500 mg/dose) for 14 days
References
- ↑
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.