Whipple's disease medical therapy

Whipple's disease Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

The mainstay of treatment for Whipple's disease is systemic long-term antibiotic therapy. Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].

Medical Therapy

• Pharmacologic medical therapy for Whipple's disease includes long-term antibiotics.

• Classic Whipple's disease
  • Initial therapy
    • Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
    • Preferred regimen (2): drug name 500 mg PO q8h for 14-21 days
    • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
  • Maintenance therapy
    • Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
    • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days

• CNS infection
  • Initial therapy
    • • Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
      • Preferred regimen (2): drug name 500 mg PO q8h for 14-21 days
      • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
  • Maintenance therapy
    • Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
    • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days

• Endocarditis
  • Initial therapy
    • • Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
      • Preferred regimen (2): drug name 500 mg PO q8h for 14-21 days
      • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
  • Maintenance therapy
    • Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
    • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days

• Relapse
  • Initial therapy
    • • Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
      • Preferred regimen (2): drug name 500 mg PO q8h for 14-21 days
      • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
  • Maintenance therapy
    • Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
    • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days

• 1. Initial Parenteral Therapy

• Preferred regimen: Ceftriaxone 2 g IV daily for 2 weeks

• 2. Long-term Therapy

• Preferred regimen: Trimethoprim-sulfamethoxazole 160/800 mg PO bid for at least 1 year
• Alternative regimen: Doxycycline 100 mg PO bid AND Hydroxychloroquine 200 mg PO tid in cases of allergy or relapse.

References

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