Sandbox Listeriosis medical therapy

Listeriosis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Listeriosis from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Screening
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
MRI
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Sandbox Listeriosis medical therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Sandbox Listeriosis medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Sandbox Listeriosis medical therapy
CDC on Sandbox Listeriosis medical therapy
Sandbox Listeriosis medical therapy in the news
Blogs on Sandbox Listeriosis medical therapy
Directions to Hospitals Treating Listeriosis
Risk calculators and risk factors for Sandbox Listeriosis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Overview

Ampicillin and penicillin G are generally recommended for treatment of Listeria monocytogenes because of its resistance to cephalosporins. Bacteremia should be treated for 2 weeks, meningitis for 3 weeks, endocarditis for 4 weeks, and brain abscess or rhomboencephalitis for at least 6 weeks. Overall mortality rate is 20-30%; of all pregnancy-related cases, 22% resulted in fetal loss or neonatal death, but mothers usually survive.

Principles of Therapy

• Listeriosis is treated with antibiotics. A person in a high-risk category who experiences flu-like symptoms within 2 months of eating contaminated food should seek medical care and tell the physician or health care provider about eating the contaminated food.

• If a person has eaten food contaminated with Listeria and does not have any symptoms, most experts believe that no tests or treatment are needed, even for persons at high risk for listeriosis.

Medical Therapy for Listeria monocytogenes Adapted from Clin Infect Dis. 1997;24(1):1-9., Clin Infect Dis. 2005;40(9):1327-32., and Clin Infect Dis. 2004;39(9):1267-84.

▸ Click on the following categories to expand treatment regimens.

L. monocytogenes Infections   ▸  Bacteremia   ▸  Brain Abscess   ▸  Endocarditis   ▸  Gastroenteritis   ▸  Meningitis   ▸  Rhombencephalitis

Listeria monocytogenes, Bacteremia¶ Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 2 mg/kg IV load, then 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 10—20 mg/kg/day IV q6—12h (TMP component) OR ▸ Meropenem 2 g IV q8h ¶ Minimum duration of therapy: 2 weeks Listeria monocytogenes, Brain Abscess† Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 2 mg/kg IV load, then 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 10—20 mg/kg/day IV q6—12h (TMP component) OR ▸ Meropenem 2 g IV q8h † Minimum duration of therapy: 6 weeks Listeria monocytogenes, Endocarditis§ Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 2 mg/kg IV load, then 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 10—20 mg/kg/day IV q6—12h (TMP component) OR ▸ Meropenem 2 g IV q8h § Minimum duration of therapy: 4—6 weeks Listeria monocytogenes, Gastroenteritis Preferred Regimen ▸ Antimicrobial therapy is not warranted in most cases. Alternative Regimen (For Outbreaks and Invasive Diseases) ▸ Ampicillin 500 mg PO q6h x 5 days OR ▸ TMP/SMZ 160/800 mg PO q12h x 5 days Listeria monocytogenes, Meningitis‡ Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 2 mg/kg IV load, then 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 10—20 mg/kg/day IV q6—12h (TMP component) OR ▸ Meropenem 2 g IV q8h ‡ Minimum duration of therapy: 3 weeks Listeria monocytogenes, Rhombencephalitis† Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 2 mg/kg IV load, then 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 10—20 mg/kg/day IV q6—12h (TMP component) OR ▸ Meropenem 2 g IV q8h † Minimum duration of therapy: 6 weeks