Relapsing fever medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
Antimicrobial therapy for relapsing fever in adults depends on the vector (Tick-borne vs. Louse-borne) and includes either [[Doxycycline]], [[Erythromycin]], or [[Tetracyclines]]. Intravenous [[Ceftriaxone]] is added if either [[meningitis]] or [[encephalitis]] is present. | [[Antimicrobial]] therapy for [[relapsing fever]] in adults depends on the [[vector]] ([[Tick-borne relapsing fever|Tick-borne]] vs. [[Louse-borne relapsing fever|Louse-borne]]) and includes either [[Doxycycline]], [[Erythromycin]], or [[Tetracyclines]]. Intravenous [[Ceftriaxone]] is added if either [[meningitis]] or [[encephalitis]] is present. | ||
==Medical Therapy== | ==Medical Therapy== | ||
Revision as of 01:39, 25 September 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2]
Overview
Antimicrobial therapy for relapsing fever in adults depends on the vector (Tick-borne vs. Louse-borne) and includes either Doxycycline, Erythromycin, or Tetracyclines. Intravenous Ceftriaxone is added if either meningitis or encephalitis is present.
Medical Therapy
Erythromycin, Tetracyclines, Chloramphenicol, or Penicillins have all been shown to be effective for treating tick-borne relapsing fever (TBRF). Although the duration of therapy has not been well studied for TBRF, the current recommendation is seven days of antibiotic therapy. In contrast, louse-borne relapsing fever (LBRF) caused by B. recurrentis can be treated with a single dose of antibiotics.
For young children and pregnant women either Erythromycin and/or Penicillin are recommended for the treatment of TBRF.
When initiating antibiotic therapy, a patient should be watched closely for a Jarisch-Herxheimer reaction for the first 4 hours after the antibiotic is given. The reaction may be difficult to distinguish from a febrile crisis, with rigors and decreased blood pressure. Cooling blankets and appropriate use of antipyretic agents may be indicated and may be lessened by giving acetaminophen 650 mg orally 2 hours before and 2 hours after the first dose of antibiotic therapy. This reaction tends to be more severe in patients with louse-borne relapsing fever treated with penicillin.
Antimicrobial regimen
- 1. Tick-Borne Relapsing Fever [1]
- Preferred regimen: Doxycycline 100 mg PO bid for 5-10 days
- Alternative regimen: Erythromycin 500 mg PO qid for 5-10 days
- Note: If meningitis/encephalitis present, use Ceftriaxone 2 g IV q12h for 14 days
- 2. Louse-Borne Relapsing Fever
- Preferred regimen: Tetracycline 500 mg PO single dose
- Alternative regimen: Erythromycin 500 mg PO single dose
References
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.