Sandbox Listeriosis medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
[[Ampicillin]] and [[penicillin G]] are generally recommended for treatment of ''[[Listeria monocytogenes]]'' because of its resistance to [[cephalosporin]]s. [[Bacteremia]] should be treated for 2 weeks, [[meningitis]] for 3 weeks, [[endocarditis]] for 4 weeks, and [[brain abscess]] or rhomboencephalitis for at least 6 weeks. Overall mortality rate is 20-30%; of all pregnancy-related cases, 22% resulted in fetal loss or neonatal death, but mothers usually survive. | [[Ampicillin]] and [[penicillin G]] are generally recommended for treatment of ''[[Listeria monocytogenes]]'' because of its resistance to [[cephalosporin]]s. [[Bacteremia]] should be treated for 2 weeks, [[meningitis]] for 3 weeks, [[endocarditis]] for 4 to 6 weeks, and [[brain abscess]] or rhomboencephalitis for at least 6 weeks. Overall mortality rate is 20-30%; of all pregnancy-related cases, 22% resulted in fetal loss or neonatal death, but mothers usually survive. | ||
==Principles of Therapy== | ==Principles of Therapy== | ||
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* [[Meningitis]] is the most common clinical manifestation, and antibiotics that penetrate well into the CSF should be chosen. | * [[Meningitis]] is the most common clinical manifestation, and antibiotics that penetrate well into the CSF should be chosen. | ||
* Addition of an [[aminoglycoside]], which provides synergistic bactericidal effects to [[ampicillin]], is generally suggested for the treatment of listerial bacteremia, endocarditis, brain abscess, meningitis, or rhomboencephalitis.<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> | * Addition of an [[aminoglycoside]], which provides synergistic bactericidal effects to [[ampicillin]], is generally suggested for the treatment of listerial [[bacteremia]], [[endocarditis]], [[brain abscess]], [[meningitis]], or rhomboencephalitis.<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> | ||
* 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 consider oral herapy with [[ampicillin]] or [[TMP/SMZ|trimethoprim-sulfamethoxazole]] for several days. | * 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 consider oral herapy with [[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> | ||
* [[Bacteremia]] should be treated for 2 weeks, [[meningitis]] for 3 weeks, [[endocarditis]] for 4 to 6 weeks, and [[brain abscess]] or rhomboencephalitis for at least 6 weeks | |||
==Medical Therapy for ''Listeria monocytogenes'' <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> ''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> and ''Clin Infect Dis. 2004;39(9):1267-84.''<ref name="pmid15494903">Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al. (2004) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15494903 Practice guidelines for the management of bacterial meningitis.] ''Clin Infect Dis'' 39 (9):1267-84. [http://dx.doi.org/10.1086/425368 DOI:10.1086/425368] PMID: [http://pubmed.gov/1549490315494903]</ref></SMALL></SMALL></SMALL></SMALL></SMALL>== | ==Medical Therapy for ''Listeria monocytogenes'' <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> ''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> and ''Clin Infect Dis. 2004;39(9):1267-84.''<ref name="pmid15494903">Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al. (2004) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15494903 Practice guidelines for the management of bacterial meningitis.] ''Clin Infect Dis'' 39 (9):1267-84. [http://dx.doi.org/10.1086/425368 DOI:10.1086/425368] PMID: [http://pubmed.gov/1549490315494903]</ref></SMALL></SMALL></SMALL></SMALL></SMALL>== |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]
Overview
Ampicillin and penicillin G are generally recommended for treatment of Listeria monocytogenes because of its resistance to cephalosporins. Bacteremia should be treated for 2 weeks, meningitis for 3 weeks, endocarditis for 4 to 6 weeks, and brain abscess or rhomboencephalitis for at least 6 weeks. Overall mortality rate is 20-30%; of all pregnancy-related cases, 22% resulted in fetal loss or neonatal death, but mothers usually survive.
Principles of Therapy
- Ampicillin, amoxicillin, and penicillin G have been considered the treatment of choice 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]
- Meningitis is the most common clinical manifestation, and antibiotics that penetrate well into the CSF should be chosen.
- Addition of an aminoglycoside, which provides synergistic bactericidal effects to ampicillin, is generally suggested for the treatment of listerial bacteremia, endocarditis, brain abscess, meningitis, or rhomboencephalitis.[2]
- 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 consider oral herapy with ampicillin or trimethoprim-sulfamethoxazole for several days.[3]
- Bacteremia should be treated for 2 weeks, meningitis for 3 weeks, endocarditis for 4 to 6 weeks, and brain abscess or rhomboencephalitis for at least 6 weeks
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]