Bartonellosis medical therapy

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

Overview

Treatment of Bartonellosis are specific for each species. Azithromycin, doxycycline and erythromycin are commonly used to treat Bartonellosis.

Medical Therapy

Pharmacotherapy

Treatment of infections caused by Bartonella species.

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

• Bartonella bacilliformis Return to Top

• 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:

• Bartonella henselae Return to Top

• Bartonella quintana Return to Top

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• Bartonellosis

• 1.Cat scratch disease

• 1.1.If extensive adenopathy

• Preferred regimen : Azithromycin 500 mg single dose

• 2.Retinitis

• Preferred regimen : Doxycycline 100 mg bid AND Rifampin 300 mg bid PO for 4-6 weeks.

• 3.Bacillary angiomatosis

• Preferred regimen : Erythromycin 500 mg PO qid OR Doxycycline 100mg PO bid for >3 months.

• 4.Peliosis hepatitis

• Preferred regimen : Erythromycin 500 mg PO qid OR Doxycycline 100 mg PO bid for 4 months.

• 5.Oroya fever

• Preferred regimen : Ciprofloxacin 500 mg PO bid for 10 days.

• 6.Endocarditis

• 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.

References

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