Ehrlichiosis medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]
Medical Therapy
- Doxycycline is the drug of choice.
- For people allergic to drugs of the tetracycline class, rifampicin is an alternative.
- Early clinical experience suggested that chloramphenicol may also be effective, however in vitro susceptibility testing revealed resistance.
- Preferred regimen: Doxycycline 100 mg IV q12h for 7-14 days
- Alternative regimen (1): Chloramphenicol
- Alternative regimen (2): Rifampin
- Pediatric regimen: Doxycycline 2.2 mg/kg PO bid (Children under 45 kg (100 lbs)) for 7-14 days
- Note: Patients should be treated for at least 3 days after the fever subsides and until there is evidence of clinical improvement
Antimicrobial regimen
- 1. Human Monocytic Ehrlichiosis or Human Granulocytic Anaplasmosis (adult) [1]
- Preferred regimen: Doxycycline 100 mg PO/IV q12h for 7-14 days
- Note: Patients should be treated for at least 3 days after the fever subsides and until there is evidence of clinical improvement
- Alternative regimen (1): Chloramphenicol 500mg PO qid
- Alternative regimen (2): Rifampin 600 mg PO/IV qd for 7-10 days
- 2. Human Monocytic Ehrlichiosis or Human Granulocytic Anaplasmosis (pediatric)
- 2.1 ≥ 8 years old
- Preferred regimen: Doxycycline 2 mg/kg IV/PO q12h (Maximum, 200 mg/day) for 10 days
- 2.2 < 8 years old without Lyme disease
- Preferred regimen: Doxycycline 2 mg/kg IV/PO q12h (Maximum, 200 mg/day) for 4-5 days (or 3 days after resolution of fever)
- 2.3 co-infected with Lyme disease
- Preferred regimen: Doxycycline, then Amoxicillin 50 mg/kg in 3 divided doses (Maximum, 500 mg/dose) OR Cefuroxime 30 mg/kg in 2 divided doses (Maximum, 500 mg/dose) for 14 days
References
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.