Rhodococcus equi: Difference between revisions
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* Rhodococcus equi<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | * Rhodococcus equi<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | ||
:* Preferred regimen: | :* Preferred regimen: | ||
Treatment (induction) lengthy: at least 4 wks or until infiltrate disappears. | |||
Some authors recommend at least 8 wks in immunocompromised pts. | |||
Combination therapy with intracellular activity recommended (see below). | |||
Suppressive therapy 3-6 mos in non HIV, often lifelong in HIV; no data on stopping if immune reconstitution on HAART. | |||
First line: vancomycin 1 g IV q12h (15 mg/kg q12 for >70 kg) or imipenem 500 mg IV q6h plus. | |||
Rifampin 600 mg PO once daily or ciprofloxacin 750 mg PO twice daily or erythromycin 500 mg PO four times a day. | |||
Oral/maintenance therapy (after infiltrate clears): ciprofloxacin 750 mg PO twice daily or erythromycin 500 mg PO four times a day. | |||
== Literature == | == Literature == | ||
Revision as of 18:55, 24 June 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Rhodococcus equi is a Gram-positive coccoid bacteria. The organism commonly lives in dry and dusty soil and can be important for diseases of domesticated animals (horses and goats). The frequency of infection reaches near 60 percent. R. equi is the most important pathogen of pneumonia of foals. In addition there is a the possibility, that the pathogen can transfer to humans. The most endangered groups are immunsupprimised people and AIDS-patients.
In taxonomies, R. equi can have the synonymes Corynebacterium equi, Bacillus hoagii, Corynebacterium purulentus, Mycobacterium equi, Mycobacterium restrictum, Nocardia restricta and Proactinomyces restrictus.
Treatment
Antimicrobial Regimen
- Rhodococcus equi[1]
- Preferred regimen:
Treatment (induction) lengthy: at least 4 wks or until infiltrate disappears.
Some authors recommend at least 8 wks in immunocompromised pts.
Combination therapy with intracellular activity recommended (see below).
Suppressive therapy 3-6 mos in non HIV, often lifelong in HIV; no data on stopping if immune reconstitution on HAART.
First line: vancomycin 1 g IV q12h (15 mg/kg q12 for >70 kg) or imipenem 500 mg IV q6h plus.
Rifampin 600 mg PO once daily or ciprofloxacin 750 mg PO twice daily or erythromycin 500 mg PO four times a day.
Oral/maintenance therapy (after infiltrate clears): ciprofloxacin 750 mg PO twice daily or erythromycin 500 mg PO four times a day.
Literature
- Monika Venner und Erich Klug: Die Rhodococcus-equi-Pneumonie beim Fohlen: Diagnose, Therapie, Prophylaxe In: Pferde spiegel Nummer 4, 2005. Seiten 155-158 PDF
- J. Ashour und M. K. Hondalus: Phenotypic mutants of the intracellular actinomycete Rhodococcus equi created by in vivo Himar1 transposon mutagenesis. In: Journal of Bacteriology. Volume 185, Nummer 8, April 2003. Seiten 2644-2652. doi:10.1128/JB.185.8.2644-2652.2003
- A. Triskatis: Semiquantitative Bestimmung von Antikörpern gegen Rhodococcus equi in Serum und Klolostrum bei Stuten und Fohlen mittels ELISA und der Vergleich mit Befunden der Lungenuntersuchung PDF
References
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.