Tropical sprue medical therapy

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

Overview

Folic acid and antimicrobial therapy are the mainstay of treatment for tropical sprue. Supportive therapy includes adequate hydration and replacement of nutrients such as iron and vitamin B. Oral Tetracycline is contraindicated in children generally until all permanent teeth have appeared.

Medical Therapy

  • Preferred regimen (1): Folic acid 5 mg PO bid for 2 weeks, followed by 1 mg PO tid AND Tetracycline 250 mg PO qid for 4–6 weeks, up to 6 months in residents of the tropics who have had long-term disease
  • Preferred regimen (2): Folic acid 5 mg PO bid for 2 weeks, followed by 1 mg PO tid AND Doxycycline 100 mg PO qd for 4–6 weeks, up to 6 months in residents of the tropics who have had long-term disease
  • Alternative regimen: Folic acid 5 mg PO bid for 2 weeks, followed by 1 mg PO tid AND Ampicillin 500 mg bid for ≥ 4 weeks
Note: Vitamin B12 deficiency may be corrected with Vitamin B12 1000 mcg IM weekly for 4 weeks, followed by monthly for 3 to 6 months.

Chronic Pharmacotherapies

Once diagnosed, tropical sprue can be treated by a course of the antibiotic tetracycline and vitamins B12 and folic acid for at least 6 months.

References

  1. Guerra, R.; Wheby, M. S.; Bayless, T. M. (1965-10). "Long-term antibiotic therapy in tropical sprue". Annals of Internal Medicine. 63 (4): 619–634. ISSN 0003-4819. PMID 5838328. Check date values in: |date= (help)
  2. Ferri, Fred (2015). Ferri's Clinical Advisor 2016 5 Books in 1. City: Elsevier Science Health Science. ISBN 978-0323280471.