Listeriosis medical therapy: Difference between revisions
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* [[Ampicillin]], [[amoxicillin]], and [[penicillin G]] have been considered effective for listeriosis. For patients unable to tolerate [[beta-lactam]]s, [[TMP/SMZ|trimethoprim-sulfamethoxazole]] may be used alternatively. [[Chloramphenicol]] is not regarded as an acceptable option due to high treatment failure and relapse rates.<ref name="Stamm-">{{Cite journal | last1 = Stamm | first1 = AM. | last2 = Dismukes | first2 = WE. | last3 = Simmons | first3 = BP. | last4 = Cobbs | first4 = CG. | last5 = Elliott | first5 = A. | last6 = Budrich | first6 = P. | last7 = Harmon | first7 = J. | title = Listeriosis in renal transplant recipients: report of an outbreak and review of 102 cases. | journal = Rev Infect Dis | volume = 4 | issue = 3 | pages = 665-82 | month = | year = | doi = | PMID = 6750737 }}</ref> | * [[Ampicillin]], [[amoxicillin]], and [[penicillin G]] have been considered effective for listeriosis. For patients unable to tolerate [[beta-lactam]]s, [[TMP/SMZ|trimethoprim-sulfamethoxazole]] may be used alternatively. [[Chloramphenicol]] is not regarded as an acceptable option due to high treatment failure and relapse rates.<ref name="Stamm-">{{Cite journal | last1 = Stamm | first1 = AM. | last2 = Dismukes | first2 = WE. | last3 = Simmons | first3 = BP. | last4 = Cobbs | first4 = CG. | last5 = Elliott | first5 = A. | last6 = Budrich | first6 = P. | last7 = Harmon | first7 = J. | title = Listeriosis in renal transplant recipients: report of an outbreak and review of 102 cases. | journal = Rev Infect Dis | volume = 4 | issue = 3 | pages = 665-82 | month = | year = | doi = | PMID = 6750737 }}</ref> | ||
* Addition of an [[aminoglycoside]], which | * Addition of an [[aminoglycoside]], which confers [[synergistic]] [[bactericidal]] effects to [[ampicillin]], is recommended for the treatment of listerial [[bacteremia]], [[endocarditis]], [[brain abscess]], [[meningitis]], or rhombencephalitis.<ref name="Gellin-1989">{{Cite journal | last1 = Gellin | first1 = BG. | last2 = Broome | first2 = CV. | title = Listeriosis. | journal = JAMA | volume = 261 | issue = 9 | pages = 1313-20 | month = Mar | year = 1989 | doi = | PMID = 2492614 }}</ref> | ||
* [[Bacteremia]] should be treated for 2 weeks, [[meningitis]] for 3 weeks, [[endocarditis]] for 4 to 6 weeks, and [[brain abscess]] or rhombencephalitis for at least 6 weeks. | * [[Bacteremia]] should be treated for 2 weeks, [[meningitis]] for 3 weeks, [[endocarditis]] for 4 to 6 weeks, and [[brain abscess]] or rhombencephalitis for at least 6 weeks. | ||
* [[Meningitis]] is the most common clinical manifestation, and antibiotics that penetrate well into the | * [[Meningitis]] is the most common clinical manifestation, and antibiotics that penetrate well into the [[cerebrospinal fluid]] should be chosen. | ||
* [[Gastroenteritis]] caused by ''[[Listeria monocytogenes]]'' is usually self-limited and complete recovery typically occurs within 2 days. Persons who have ingested food implicated in outbreaks and who have a high risk of invasive illness may be treated with oral [[ampicillin]] or [[TMP/SMZ|trimethoprim-sulfamethoxazole]] for several days.<ref name="Lorber-1997">{{Cite journal | last1 = Lorber | first1 = B. | title = Listeriosis. | journal = Clin Infect Dis | volume = 24 | issue = 1 | pages = 1-9; quiz 10-1 | month = Jan | year = 1997 | doi = | PMID = 8994747 }}</ref> | * [[Gastroenteritis]] caused by ''[[Listeria monocytogenes]]'' is usually self-limited and complete recovery typically occurs within 2 days. Persons who have ingested food implicated in outbreaks and who have a high risk of invasive illness may be treated with oral [[ampicillin]] or [[TMP/SMZ|trimethoprim-sulfamethoxazole]] for several days.<ref name="Lorber-1997">{{Cite journal | last1 = Lorber | first1 = B. | title = Listeriosis. | journal = Clin Infect Dis | volume = 24 | issue = 1 | pages = 1-9; quiz 10-1 | month = Jan | year = 1997 | doi = | PMID = 8994747 }}</ref> | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
Revision as of 14:56, 22 July 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]
Overview
Ampicillin, with or without gentamicin, is considered the drug of choice for listeriosis. Patients intolerant of penicillins may be managed with trimethoprim-sulfamethoxazole alternatively. Suggested minimum duration of therapy depends on clinical manifestations: bacteremia for 2 weeks, meningitis for 3 weeks, endocarditis for 4 to 6 weeks, and brain abscess or rhombencephalitis for at least 6 weeks.
Principles of Therapy
- Ampicillin, amoxicillin, and penicillin G have been considered effective for listeriosis. For patients unable to tolerate beta-lactams, trimethoprim-sulfamethoxazole may be used alternatively. Chloramphenicol is not regarded as an acceptable option due to high treatment failure and relapse rates.[1]
- Addition of an aminoglycoside, which confers synergistic bactericidal effects to ampicillin, is recommended for the treatment of listerial bacteremia, endocarditis, brain abscess, meningitis, or rhombencephalitis.[2]
- Bacteremia should be treated for 2 weeks, meningitis for 3 weeks, endocarditis for 4 to 6 weeks, and brain abscess or rhombencephalitis for at least 6 weeks.
- Meningitis is the most common clinical manifestation, and antibiotics that penetrate well into the cerebrospinal fluid should be chosen.
- Gastroenteritis caused by Listeria monocytogenes is usually self-limited and complete recovery typically occurs within 2 days. Persons who have ingested food implicated in outbreaks and who have a high risk of invasive illness may be treated with oral ampicillin or trimethoprim-sulfamethoxazole for several days.[3]
Medical Therapy for Listeria monocytogenes Adapted from Clin Infect Dis. 1997;24(1):1-9.,[3] Clin Infect Dis. 2005;40(9):1327-32.,[4] and Clin Infect Dis. 2004;39(9):1267-84.[5]
▸ Click on the following categories to expand treatment regimens.
L. monocytogenes Infections ▸ Bacteremia ▸ Brain Abscess ▸ Endocarditis ▸ Gastroenteritis ▸ Meningitis ▸ Rhombencephalitis |
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References
- ↑ Stamm, AM.; Dismukes, WE.; Simmons, BP.; Cobbs, CG.; Elliott, A.; Budrich, P.; Harmon, J. "Listeriosis in renal transplant recipients: report of an outbreak and review of 102 cases". Rev Infect Dis. 4 (3): 665–82. PMID 6750737.
- ↑ Gellin, BG.; Broome, CV. (1989). "Listeriosis". JAMA. 261 (9): 1313–20. PMID 2492614. Unknown parameter
|month=
ignored (help) - ↑ 3.0 3.1 Lorber, B. (1997). "Listeriosis". Clin Infect Dis. 24 (1): 1–9, quiz 10-1. PMID 8994747. Unknown parameter
|month=
ignored (help) - ↑ Ooi, ST.; Lorber, B. (2005). "Gastroenteritis due to Listeria monocytogenes". Clin Infect Dis. 40 (9): 1327–32. doi:10.1086/429324. PMID 15825036. Unknown parameter
|month=
ignored (help) - ↑ Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al. (2004) Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39 (9):1267-84. DOI:10.1086/425368 PMID: [1]