Yersinia pestis infection medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
A plague vaccine is not currently available for use in the United States.
According to treatment experts, a patient diagnosed with suspected plague should be hospitalized and medically isolated. Laboratory tests should be done, including blood cultures for plague bacteria and microscopic examination of lymph gland, blood, and sputum samples. Antibiotic treatment should begin as soon as possible after laboratory specimens are taken. Effective antibiotics are:
- Streptomycin (First line)
- Gentamicin (Used when streptomycin is not available)
- Chloramphenicol (Used for critically ill patients, or rarely for suspected neuro-involvement)
Persons who have been in close contact with a plague patient, particularly a patient with plague pneumonia, should be identified and evaluated. The U.S. Public Health Service requires that all cases of suspected plague be reported immediately to local and state health departments and that the diagnosis be confirmed by CDC. As required by the International Health Regulations, CDC reports all U.S. plague cases to the World Health Organization.
Medical Therapy
Early treatment of pneumonic plague is essential. To prevent a high risk of death, antibiotics should be given within 24 hours of the first symptoms. Several types of antibiotics are effective for curing the disease and for preventing it.
Oral
- tetracycline (such as doxycycline)
- fluoroquinolone (such as ciprofloxacin).
Injection or intravenous medications (Preferred in pulmonary or advanced cases)
Early in the response to a bioterrorism attack, the above drugs would be tested to determine which is most effective against the particular weapon that was used.
Antibiotic treatment for 7 days will protect people who have had direct, close contact with infected patients. Wearing a close-fitting surgical mask also protects against infection. However, antibiotic treatment alone is insufficient for some patients, who may also require circulatory, ventilator, or renal support.
In an emergency department setting, Harrison's Principles of Internal Medicine outlines the following treatment course.[1]
Resources
References
- ↑ Jameson, J. N. St C.; Dennis L. Kasper; Harrison, Tinsley Randolph; Braunwald, Eugene; Fauci, Anthony S.; Hauser, Stephen L; Longo, Dan L. (2005). Harrison's principles of internal medicine. New York: McGraw-Hill Medical Publishing Division. ISBN 0-07-140235-7.