Q fever medical therapy: Difference between revisions

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Latest revision as of 23:55, 29 July 2020


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Q fever Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Q fever from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary prevention

Secondary prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

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Risk calculators and risk factors for Q fever medical therapy

Overview

The mainstay of therapy for Q fever is doxycycline. The chronic form of Q fever is more difficult to treat and can require up to two years of treatment with doxycycline and hydroxychloroquine. Q fever in pregnancy is especially difficult to treat because doxycycline is contraindicated in pregnancy, so preferred treatment is trimethoprim/sulfamethoxazole.

Medical Therapy

Antimicrobial Regimen

  • 1. Acute Q fever
  • 1.1 Adults
  • Preferred Regimen: Doxycycline 100 mg PO bid for 14 days
  • 1.2 Children
  • 1.2.1 Children with age ≥ 8 years
  • Preferred regimen: Doxycycline 2.2 mg/kg PO bid for 14 days (maximum 100 mg per dose)
  • 1.2.2 Children with age < 8 years with high risk criteria
  • Preferred regimen: Doxycycline 2.2 mg/kg PO bid for 14 days (maximum: 100 mg per dose)
  • 1.2.3 Children with age < 8 years with mild or uncomplicated illness
  • Preferred regimen: Doxycycline 2.2 mg/kg PO bid for 5 days (maximum 100 mg per dose).
  • 1.2.3 Children with age < 8 years with mild or uncomplicated illness who remain febrile past 5 days of treatment
  • 1.3 Pregnant women
  • 2. Chronic Q fever
  • 2.1 Endocarditis or vascular infection
  • Preferred regimen: Doxycycline 100 mg PO bid AND Hydroxychloroquine 200 mg PO tid for ≥18 months
  • Note: Consultation recommended for children and pregnant women.
  • 2.2 Noncardiac organ disease
  • Preferred regimen: Doxycycline 100 mg PO bid AND Hydroxychloroquine 200 mg PO tid
  • Note: Consultation recommended for children and pregnant women.
  • 2.3 Postpartum with serologic profile for chronic Q fever
  • Preferred regimen: Doxycycline 100 mg PO bid AND Hydroxychloroquine 200 mg PO tid for 12 months
  • Note (1): Women should only be treated postpartum if serologic titers remain elevated >12 months after delivery (immunoglobulin G phase I titer ≥1:1024). Women treated during pregnancy for acute Q fever should be monitored similarly to other patients who are at high risk for progression to chronic disease (e.g., serologic monitoring at 3, 6, 12, 18, and 24 months after delivery)
  • Note (2): There is no current recommendation for Post-Q fever fatigue syndrome

References

  1. "q fever".


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