Sandbox Listeriosis medical therapy: Difference between revisions
Gerald Chi (talk | contribs) (Created page with "__NOTOC__ {{Listeriosis}} {{CMG}} ==Overview== Bacteremia should be treated for 2 weeks, meningitis for 3 weeks, and brain abscess for at least 6 weeks. Amoxi...") |
Gerald Chi- (talk | contribs) (/* Organ-Based Therapy for Listeria monocytogenes Infection Adapted from Clin Infect Dis. 1997;24(1):1-9.{{Cite journal | last1 = Lorber | first1 = B. | title = Listeriosis. | journal = Clin Infect Dis | volume = 24 | issue = 1 | pages = 1-9; quiz 10-...) |
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==Antimicrobial Therapy for ''Listeria monocytogenes'' Infection <SMALL><SMALL><SMALL><SMALL><SMALL>Adapted from ''Clin Infect Dis. 1997;24(1):1-9.''<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> and ''Clin Infect Dis. 2005;40(9):1327-32.''<ref name="Ooi-2005">{{Cite journal | last1 = Ooi | first1 = ST. | last2 = Lorber | first2 = B. | title = Gastroenteritis due to Listeria monocytogenes. | journal = Clin Infect Dis | volume = 40 | issue = 9 | pages = 1327-32 | month = May | year = 2005 | doi = 10.1086/429324 | PMID = 15825036 }}</ref></SMALL></SMALL></SMALL></SMALL></SMALL>== | |||
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL> | <SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL> | ||
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▸ '''Gastroenteritis''' | |||
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▸ '''Bacteremia''' | ▸ '''Bacteremia''' | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Preferred Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Preferred Regimen''''' | ||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ampicillin]] 200 mg/kg IV q4h x ≥3 weeks''''' | ||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS | ||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Gentamicin]] 5 mg/kg IV q8h x ≥3 weeks''''' | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Alternative Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Alternative Regimen''''' | ||
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! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF| | ! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Listeria monocytogenes'', Brain Abscess}} | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Preferred Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Preferred Regimen''''' | ||
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{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | {| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | ||
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF| | ! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Listeria monocytogenes'', Rhombencephalitis}} | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Preferred Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Preferred Regimen''''' | ||
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{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | {| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | ||
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF| | ! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Listeria monocytogenes'', Endocarditis}} | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Preferred Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Preferred Regimen''''' | ||
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{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | {| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | ||
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF| | ! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Listeria monocytogenes'', Gastroenteritis}} | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Preferred Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Preferred Regimen''''' | ||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ ''''' | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ Antimicrobial therapy is <u>'''not'''</u> warranted in most cases. | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Alternative Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Alternative Regimen''''' <BR> <SMALL> (for Outbreaks and Invasive Diseases) </SMALL> | ||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ampicillin]] 500 mg IV q6h x 5 days'''''<BR> OR <BR> ▸ '''''[[TMP/SMZ]] 160/800 mg PO q12h x 5 days''''' | ||
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{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | {| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | ||
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF| | ! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Listeria monocytogenes'', Bacteremia}} | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Preferred Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Preferred Regimen''''' | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Alternative Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=center | '''''Alternative Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Chloramphenicol]] 1—1.5 g IV q6h'''''<BR> OR <BR> ▸ '''''[[Cefepime]] 2 g IV q8h'''''<BR> OR<BR> ▸ '''''[[Meropenem]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]] 400 mg IV q24h''''' | ||
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==References== | ==References== |
Revision as of 16:17, 23 February 2014
Listeriosis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Bacteremia should be treated for 2 weeks, meningitis for 3 weeks, and brain abscess for at least 6 weeks.
Amoxicillin-based regimen is considered the treatment of choice for Listeria meningitis because of its resistance to cephalosporins.
Overall mortality rate is 20-30%; of all pregnancy-related cases, 22% resulted in fetal loss or neonatal death, but mothers usually survive.
Medical 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.
Amoxicillin, ampicillin, or penicillin G is the treatment of choice for Listeria meningitis.30 Some authorities have recommended the addition of an aminoglycoside because of enhanced in-vitro killing and in-vivo synergy in animal models. No study has been done to compare amoxicillin or ampicillin alone versus amoxicillin or ampicillin plus gentamicin, although retrospective clinical data suggest that the addition of gentamicin can reduce mortality.31 By contrast, in a cohort of 118 patients with listeriosis, the aminoglycoside-treated group had increased rates of kidney injury and mortality.32 Trimethoprim-sulfamethoxazole is an alternative treat- ment in patients who are allergic to or intolerant of penicillin. In a retrospective study,33 treatment with trimethoprim-sulfamethoxazole plus ampicillin was associated with a lower antibiotic failure rate and fewer neurological sequelae than was the combination of ampicillin plus an aminoglycoside
Antimicrobial Therapy for Listeria monocytogenes Infection Adapted from Clin Infect Dis. 1997;24(1):1-9.[1] and Clin Infect Dis. 2005;40(9):1327-32.[2]
▸ Click on the following categories to expand treatment regimens.
Listeria monocytogenes ▸ Meningitis ▸ Brain Abscess ▸ Rhombencephalitis ▸ Endocarditis ▸ Gastroenteritis ▸ Bacteremia |
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References
- ↑ 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)