Bartonellosis medical therapy: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
m (Changes made per Mahshid's request)
 
(4 intermediate revisions by 2 users not shown)
Line 3: Line 3:
{{CMG}}
{{CMG}}
==Overview==
==Overview==
Treatment of Bartonellosis are specific for each species. [[Azithromycin]], [[doxycycline]] and [[erythromycin]] are commonly used to treat [[Bartonellosis]]. ==Treatment==
 
Treatment is dependent on which strain of ''Bartonella'' is found in a given patient. While ''Bartonella'' species are susceptible to a number of standard antibiotics ''[[in vitro]]''&mdash;[[macrolide]]s and [[Tetracycline antibiotics|tetracycline]], for example&mdash;the efficacy of antibiotic treatment in immunocompetent individuals is uncertain.<ref name=Rolain_2004 /> Immunocompromised patients should be treated with antibiotics because they are particularly susceptible to systemic disease and bacteremia. Drugs of particular effectiveness include [[trimethoprim-sulfamethoxazole]], [[gentamicin]], [[ciprofloxacin]], and [[rifampin]]; ''B. henselae'' is generally resistant to [[penicillin]], [[amoxicillin]], and nafcillin.<ref name=Rolain_2004 />
The mainstay of therapy for bartonellosis is antimicrobial therapy.


==Medical Therapy==
==Medical Therapy==
===Pharmacotherapy===
===Pharmacotherapy===
Treatment of Bartonellosis are specific for each species. [[Azithromycin]], [[Doxycycline]] and [[Erythromycin]] are commonly used to treat Bartonellosis. While Bartonella species are susceptible to a number of standard antibiotics in vitro—macrolides and [[tetracycline]]s, for example—the efficacy of antibiotic treatment in immunocompetent individuals is uncertain.[1] Immunocompromised patients should be treated with antibiotics because they are particularly susceptible to systemic disease and bacteremia. Drugs of particular effectiveness include [[Trimethoprim-sulfamethoxazole]], [[Gentamicin]], [[Ciprofloxacin]], and [[Rifampin]]; B. henselae is generally resistant to [[Penicillin]], [[Amoxicillin]], and [[Nafcillin]].[1]
Treatment of infections caused by ''[[Bartonella]]'' species.<ref>{{cite journal |author=Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D |title=Recommendations for treatment of human infections caused by Bartonella species |journal=Antimicrob. Agents Chemother. |volume=48 |issue=6 |pages=1921–33 |year=2004 |month=June |pmid=15155180 |pmc=415619 |doi=10.1128/AAC.48.6.1921-1933.2004 |url=http://aac.asm.org/cgi/pmidlookup?view=long&pmid=15155180}}</ref><ref>{{cite journal |author=Blanco JR, Raoult D |title=[Diseases produced by Bartonella] |language=Spanish; Castilian |journal=Enferm. Infecc. Microbiol. Clin. |volume=23 |issue=5 |pages=313–9; quiz 320 |year=2005 |month=May |pmid=15899181 |url=http://linkinghub.elsevier.com/retrieve/pii/13074971}}</ref>
Treatment of infections caused by ''[[Bartonella]]'' species.<ref>{{cite journal |author=Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D |title=Recommendations for treatment of human infections caused by Bartonella species |journal=Antimicrob. Agents Chemother. |volume=48 |issue=6 |pages=1921–33 |year=2004 |month=June |pmid=15155180 |pmc=415619 |doi=10.1128/AAC.48.6.1921-1933.2004 |url=http://aac.asm.org/cgi/pmidlookup?view=long&pmid=15155180}}</ref><ref>{{cite journal |author=Blanco JR, Raoult D |title=[Diseases produced by Bartonella] |language=Spanish; Castilian |journal=Enferm. Infecc. Microbiol. Clin. |volume=23 |issue=5 |pages=313–9; quiz 320 |year=2005 |month=May |pmid=15899181 |url=http://linkinghub.elsevier.com/retrieve/pii/13074971}}</ref>
{| class="wikitable"
{| class="wikitable"
Line 44: Line 46:
|-
|-
| [[Carrion's disease|Carrión´s disease]] (chronic phase: ''Verruga peruana'')
| [[Carrion's disease|Carrión´s disease]] (chronic phase: ''Verruga peruana'')
| Rifampin or [[macrolides]]
| [[Rifampin]] or [[macrolides]]
| Rifampin or macrolides
| [[Rifampin]] or [[macrolide]]s
|}
|}


===Anti microbial regimen===
===Anti microbial regimen===


{{PBI|Bartonella bacilliformis}}
:* 1. '''Carrion´s disease or Oroya fever (acute phase of infection) and Verruga peruana or Peruvian wart (chronic phase of infection)'''
::* Preferred regimen:
::* Alternative regimen:
{{PBI|Bartonella henselae}}
{{PBI|Bartonella quintana}}
----


:*Bartonellosis<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>
:* Bartonella<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>
::* '''1.Cat scratch disease'''
::* 1. '''Bartonella quintana'''
:::*1.1.If extensive adenopathy
:::* 1.1 '''Acute or chronic infections without endocarditis'''<ref name="pmid12821469">{{cite journal| author=Foucault C, Raoult D, Brouqui P| title=Randomized open trial of gentamicin and doxycycline for eradication of Bartonella quintana from blood in patients with chronic bacteremia. | journal=Antimicrob Agents Chemother | year= 2003 | volume= 47 | issue= 7 | pages= 2204-7 | pmid=12821469 | doi= | pmc=PMC161867 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12821469  }} </ref>
::::*Preferred regimen : [[Azithromycin]] 500 mg single dose
::::* Preferred regimen: [[Doxycycline]] 200 mg PO qd or 100 mg bid for 4 weeks {{and}} [[Gentamicin]] 3 mg/kg IV qd for the first 2 weeks
::* '''2.Retinitis'''
:::* 1.2 '''Endocarditis'''<ref name="pmid15956145">{{cite journal| author=Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME et al.| title=Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal=Circulation | year= 2005 | volume= 111 | issue= 23 | pages= e394-434 | pmid=15956145 | doi=10.1161/CIRCULATIONAHA.105.165564 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15956145  }} </ref>
:::*Preferred regimen : [[Doxycycline]] 100 mg bid {{and}} [[Rifampin]] 300 mg bid PO for 4-6 weeks.
::::* Preferred regimen: [[Gentamicin]] 3 mg/kg/day IV q8h for 14 days {{and}} [[Ceftriaxone]] 2 g IV q24h for 6 weeks {{withorwithout}} [[Doxycycline]] 100 mg PO bid for 6 weeks
::* '''3.Bacillary angiomatosis'''
::* 2. '''Bartonella elizabethae'''
:::*Preferred regimen : [[Erythromycin]] 500 mg PO qid {{or}} [[Doxycycline]] 100mg PO bid for >3 months.
:::* 2.1 '''Endocarditis'''<ref name="pmid15956145">{{cite journal| author=Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME et al.| title=Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal=Circulation | year= 2005 | volume= 111 | issue= 23 | pages= e394-434 | pmid=15956145 | doi=10.1161/CIRCULATIONAHA.105.165564 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15956145  }} </ref>
::* '''4.Peliosis hepatitis'''
::::* Preferred regimen: [[Gentamicin]] 3 mg/kg/day IV q8h for 14 days {{and}}  [[Ceftriaxone]] 2 g IV q24h for 6 weeks {{withorwithout}} [[Doxycycline]] 100 mg PO bid for 6 weeks
:::*Preferred regimen : [[Erythromycin]] 500 mg PO qid {{or}} [[Doxycycline]] 100 mg PO bid for 4 months.
::* 3. '''Bartonella bacilliformis'''
::* '''5.Oroya fever'''
:::* 3.1 '''Oroya fever'''
:::*Preferred regimen : [[Ciprofloxacin]] 500 mg PO bid for 10 days.
::::* Preferred regimen: [[Ciprofloxacin]] 500 mg PO bid for 14 days
::* '''6.Endocarditis'''
::::* Note: If severe disease, add [[Ceftriaxone]] 1 g IV qd for 14 days
:::*Preferred regimen : [[Gentamicin]] 3 mg/kg/day IV q8h for 14 days {{and}} [[Ceftriaxone]] 2 g/day IV for 6 weeks with or without [[Doxycycline]] 100 mg PO bid for 6 weeks.
:::* 3.2 '''Verruga peruana'''<ref>Bradley JS, Jackson MA, Committee on Infectious Diseases, American Academy of Pediatrics. The use of systemic and topical fluoroquinolones. Pediatrics 2011; 128:e1034.</ref>
::::* Preferred regimen: [[Azithromycin]] 500 mg PO qd for 7 days
::::* Alternative regimen (1): [[Rifampin]] 600 mg PO qd for 14-21 days
::::* Alternative regimen (2): [[Ciprofloxacin]] 500 mg bid for 7-10 days
::* 4. '''Bartonella henselae'''<ref name="pmid15155180">{{cite journal| author=Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D| title=Recommendations for treatment of human infections caused by Bartonella species. | journal=Antimicrob Agents Chemother | year= 2004 | volume= 48 | issue= 6 | pages= 1921-33 | pmid=15155180 | doi=10.1128/AAC.48.6.1921-1933.2004 | pmc=PMC415619 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15155180  }} </ref>
:::* 4.1 '''Cat scratch disease'''
::::* No treatment recommended for typical cat scratch disease, consider treatment if there is an extensive lymphadenopathy
::::* 4.1.1 '''If extensive lymphadenopathy'''
:::::* Preferred regimen (1) (pediatrics): [[Azithromycin]] 500 mg PO on day 1 {{then}} 250 mg PO qd on days 2 to 5
:::::* Preferred regimen (2) (adults): [[Azithromycin]] 1 g PO at day 1 {{then}} 500 mg PO for 4 days  
:::* 4.2 '''Endocarditis'''
::::* Preferred regimen: [[Gentamicin]] 3 mg/kg/day IV q8h for 14 days {{and}} [[Ceftriaxone]] 2 g/day IV for 6weeks {{withorwithout}} [[Doxycycline]] 100 mg PO bid for 6 weeks
:::* 4.3 '''Retinitis'''
::::* Preferred regimen: [[Doxycycline]] 100 mg bid {{and}}  [[Rifampin]] 300 mg bid PO for 4-6 weeks
:::* 4.4 '''Bacillary angiomatosis'''<ref name="pmid9494835">{{cite journal| author=Spach DH, Koehler JE| title=Bartonella-associated infections. | journal=Infect Dis Clin North Am | year= 1998 | volume= 12 | issue= 1 | pages= 137-55 | pmid=9494835 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9494835  }} </ref>
::::* Preferred regimen (1): [[Erythromycin]] 500 mg PO qid for 2 months at least
::::* Preferred regimen (2): [[Doxycycline]] 100 mg PO bid for 2 months at least
:::* 4.5 '''Bacillary Pelliosis'''<ref name="pmid9494835">{{cite journal| author=Spach DH, Koehler JE| title=Bartonella-associated infections. | journal=Infect Dis Clin North Am | year= 1998 | volume= 12 | issue= 1 | pages= 137-55 | pmid=9494835 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9494835  }} </ref>
::::* Preferred regimen (1): [[Erythromycin]] 500 mg PO qid  for 4 months at least
::::* Preferred regimen (2): [[Doxycycline]] 100 mg PO bid for 4 months at least


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Infectious disease]]
 
[[Category:Disease]]
[[Category:Disease]]
[[Category: Infectious Disease Project]]
[[Category: Infectious Disease Project]]
{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}

Latest revision as of 17:08, 18 September 2017

Bartonellosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Bartonellosis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Bartonellosis medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Bartonellosis medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Bartonellosis medical therapy

CDC on Bartonellosis medical therapy

Bartonellosis medical therapy in the news

Blogs on Bartonellosis medical therapy

Directions to Hospitals Treating Bartonellosis

Risk calculators and risk factors for Bartonellosis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The mainstay of therapy for bartonellosis is antimicrobial therapy.

Medical Therapy

Pharmacotherapy

Treatment of Bartonellosis are specific for each species. Azithromycin, Doxycycline and Erythromycin are commonly used to treat Bartonellosis. While Bartonella species are susceptible to a number of standard antibiotics in vitro—macrolides and tetracyclines, for example—the efficacy of antibiotic treatment in immunocompetent individuals is uncertain.[1] Immunocompromised patients should be treated with antibiotics because they are particularly susceptible to systemic disease and bacteremia. Drugs of particular effectiveness include Trimethoprim-sulfamethoxazole, Gentamicin, Ciprofloxacin, and Rifampin; B. henselae is generally resistant to Penicillin, Amoxicillin, and Nafcillin.[1]

Treatment of infections caused by Bartonella species.[1][2]

Disease Adults Children
Cat scratch disease no recommendation no recommendation
Retinitis Doxycycline + Rifampin unknown
Trench fever or chronic bacteremia by B.quintana Doxycycline + Gentamicin unknown
Bacillary angiomatosis Erythromycin or Doxycycline Erythromycin
Peliosis hepatis Erythromycin or Doxycycline Erythromycin
Endocarditis Doxycycline + Gentamicin + Rifampin or Ceftriaxone + Gentamicin
Carrión´s disease (acute phase) Ciprofloxacin or Chloramphenicol Chloramphenicol + beta-lactam
Carrión´s disease (chronic phase: Verruga peruana) Rifampin or macrolides Rifampin or macrolides

Anti microbial regimen

  • 1. Bartonella quintana
  • 1.1 Acute or chronic infections without endocarditis[4]
  • Preferred regimen: Doxycycline 200 mg PO qd or 100 mg bid for 4 weeks AND Gentamicin 3 mg/kg IV qd for the first 2 weeks
  • 1.2 Endocarditis[5]
  • 2. Bartonella elizabethae
  • 2.1 Endocarditis[5]
  • 3. Bartonella bacilliformis
  • 3.1 Oroya fever
  • Preferred regimen: Ciprofloxacin 500 mg PO bid for 14 days
  • Note: If severe disease, add Ceftriaxone 1 g IV qd for 14 days
  • 3.2 Verruga peruana[6]
  • Preferred regimen: Azithromycin 500 mg PO qd for 7 days
  • Alternative regimen (1): Rifampin 600 mg PO qd for 14-21 days
  • Alternative regimen (2): Ciprofloxacin 500 mg bid for 7-10 days
  • 4. Bartonella henselae[7]
  • 4.1 Cat scratch disease
  • No treatment recommended for typical cat scratch disease, consider treatment if there is an extensive lymphadenopathy
  • 4.1.1 If extensive lymphadenopathy
  • Preferred regimen (1) (pediatrics): Azithromycin 500 mg PO on day 1 THEN 250 mg PO qd on days 2 to 5
  • Preferred regimen (2) (adults): Azithromycin 1 g PO at day 1 THEN 500 mg PO for 4 days
  • 4.2 Endocarditis
  • 4.3 Retinitis
  • 4.4 Bacillary angiomatosis[8]
  • Preferred regimen (1): Erythromycin 500 mg PO qid for 2 months at least
  • Preferred regimen (2): Doxycycline 100 mg PO bid for 2 months at least
  • 4.5 Bacillary Pelliosis[8]
  • Preferred regimen (1): Erythromycin 500 mg PO qid for 4 months at least
  • Preferred regimen (2): Doxycycline 100 mg PO bid for 4 months at least

References

  1. ↑ Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D (2004). "Recommendations for treatment of human infections caused by Bartonella species". Antimicrob. Agents Chemother. 48 (6): 1921–33. doi:10.1128/AAC.48.6.1921-1933.2004. PMC 415619. PMID 15155180. Unknown parameter |month= ignored (help)
  2. ↑ Blanco JR, Raoult D (2005). "[Diseases produced by Bartonella]". Enferm. Infecc. Microbiol. Clin. (in Spanish; Castilian). 23 (5): 313–9, quiz 320. PMID 15899181. Unknown parameter |month= ignored (help)
  3. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  4. ↑ Foucault C, Raoult D, Brouqui P (2003). "Randomized open trial of gentamicin and doxycycline for eradication of Bartonella quintana from blood in patients with chronic bacteremia". Antimicrob Agents Chemother. 47 (7): 2204–7. PMC 161867. PMID 12821469.
  5. ↑ 5.0 5.1 Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME; et al. (2005). "Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America". Circulation. 111 (23): e394–434. doi:10.1161/CIRCULATIONAHA.105.165564. PMID 15956145.
  6. ↑ Bradley JS, Jackson MA, Committee on Infectious Diseases, American Academy of Pediatrics. The use of systemic and topical fluoroquinolones. Pediatrics 2011; 128:e1034.
  7. ↑ Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D (2004). "Recommendations for treatment of human infections caused by Bartonella species". Antimicrob Agents Chemother. 48 (6): 1921–33. doi:10.1128/AAC.48.6.1921-1933.2004. PMC 415619. PMID 15155180.
  8. ↑ 8.0 8.1 Spach DH, Koehler JE (1998). "Bartonella-associated infections". Infect Dis Clin North Am. 12 (1): 137–55. PMID 9494835.

Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Bartonellosis_medical_therapy&oldid=1353934"