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): Ceftriaxone 2 g IV qd for 14 days
  • Preferred regimen (2): Penicillin G 2 million units IV q4h for 14 days
  • Alternative regimen (1): Meropenem 1 g IV q8h for 14 days
• Maintenance therapy
  • Preferred regimen (1):
  • Alternative regimen (1):

CNS infection

• Initial therapy
  • Preferred regimen (1): Ceftriaxone 2 g IV qd for 14 days
  • Preferred regimen (2): Penicillin G 2 million units IV q4h for 14 days
  • Alternative regimen (1): Meropenem 1 g IV q8h for 14 days
• Maintenance therapy
  • Preferred regimen (1):
  • Alternative regimen (1):

Endocarditis

• Initial therapy
  • Preferred regimen (1): Ceftriaxone 2 g IV qd for 14 days
  • Preferred regimen (2): Penicillin G 2 million units IV q4h for 14 days
  • Alternative regimen (1): Meropenem 1 g IV q8h for 14 days
• Maintenance therapy
  • Preferred regimen (1):
  • Alternative regimen (1):

Relapse

• Initial therapy
  • Preferred regimen (1): Ceftriaxone 2 g IV qd for 14 days
  • Preferred regimen (2): Penicillin G 2 million units IV q4h for 14 days
  • Alternative regimen (1): Meropenem 1 g IV q8h for 14 days
• Maintenance therapy
  • Preferred regimen (1):
  • Alternative regimen (1):

• 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

References

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