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Anaplasmosis

• Human granulocytic anaplasmosis, suspected or symptomatic

• Preferred regimen: Doxycycline 100 mg orally bid (or intravenously for those patients unable to take an oral medication) for 10 days
• Alternative regimen: Rifampin 300 mg orally bid for 7–10 days (For patients with mild illness due to HGA who are not optimally suited for doxycycline treatment because of a history of drug allergy, pregnancy, or age <8 years)
• Pediatric regimen: Doxycycline 4 mg/kg per day in 2 divided doses (maximum of 100 mg per dose) given orally (or intravenously for children unable to take an oral medication); Rifampin 10 mg/kg bid for children (maximum of 300 mg per dose) (For children age <8 years without Lyme disease)

NOTE (1): Children ≥8 years of age may be treated with a 10-day course of Doxycycline; For severely ill children <8 years of age without concomitant Lyme disease, the panel recommended an abbreviated treatment course of 4–5 days

NOTE (2): If the patient has concomitant Lyme disease, then Amoxicillin 50 mg/kg per day in 3 divided doses (maximum of 500 mg per dose) OR Cefuroxime axetil 30 mg/kg per day in 2 divided doses (maximum of 500 mg per dose) should be initiated at the conclusion of the course of Doxycycline to complete a 14-day total course of antibiotic therapy

NOTE: Rifampin is not effective therapy for Lyme disease, patients coinfected with B. burgdorferi should also be treated with Amoxicillin OR Cefuroxime axetil