Antibiotic therapy plague

Post-exposure antibiotic therapies for plague and anthrax are generally effective if administered within a day or so after exposure. There is no approved therapy for smallpox, but cidofavir and possibly vaccinia-immune globulin (VIG) are showing some promise. 

If treated with antibiotics, buboes typically recede in 10 to 14 days and do not require drainage. Patients are unlikely to survive primary pneumonic plague if antibiotic therapy is not initiated within 18 hours of the onset of symptoms. Without treatment, mortality is 60% for bubonic plague and 100% for the pneumonic and septicemic forms.53... 

Those individuals closely associated with the patient, particularly in cases with pneumonia, should be traced, identitled, and evaluated. Contacts of pneumonic plague patients should be placed under observation or given preventive antibiotic therapy, depending on the degree and timing of contact. 

Clinical Diagnosis A presumptive diagnosis can be made from by Gram or Wayson stain of lymph node aspirates, sputum, or cerebrospinal fluid. Plague can also be cultured. As for treatment, early administration of antibiotics is very effective. Supportive therapy for pneumonic and septicemic forms is required. 

Second, we have to compare the rate of scientific progress in the AIDS epidemic with other epidemics that have had great impacts on society for example, the Black Death (plague) caused by Yersinia pestis. Plague caused a major epidemic in the fifth century and a second major epidemic in the fourteenth century. The infectious agent Yersina pestis was isolated in 1908. Effective therapy against the disease had to wait for the development of classical antibiotics in the 1940s. 

The historical antibiotic of choice for the treatment of plague has been streptomycin. Gentamicin is another preferred antibiotic. Alternative regimens include doxycycline, ciprofloxacin, and chloramphenicol. Patients with pneumonic plague may also require advanced medical supportive therapy in addition to antibiotics. 

As for the treatment of plague, streptomycin and gentamicin are the drugs of choice. Doxycycline and chloramphenicol have also been used, but more treatment failures have been reported with these regimens. Ciprofloxacin is another alternative therapy. For the first-line regimens as well as ciprofloxacin, a 10-day course of intravenous antibiotics is recommended. For second-line therapies, 14 days are recommended. 

Plague pneumonia is almost always fatal if treatment is not initiated within 24 hours of the onset of symptoms. A number of readily available, broad-spectrum antibiotics have shown efficacy. Specific broad-spectrum antibiotics are also recommended for post-exposure treatment against tularemia and Q fever. A licensed trivalent equine antitoxin available from CDC is the only approved therapy for airborne botulism. 

During a pneumonic plague epidemic, all persons developing a fever of 38.5°C or above or a new cough should begin parenteral antibiotics (23). Infants with tachypnea should also receive treatment (23). In a mass outbreak, in which parenteral therapy may not be available, the Working Group recommends oral therapy for adults with doxycycline (or tetracycline or ciprofloxacin) children should receive doxycycline (see Table 2.11). 

Hospital personnel who are observing recommended isolation procedures do not require prophylactic therapy, nor do contacts of patients with bubonic plague. However, people who were in the same environment and who were potentially exposed to the same source of infection as the contact case should be given prophylactic antibiotics. In addition, previously vaccinated individuals should receive prophylactic antibiotics if they have been exposed to a plague aerosol. 

As soon as a diagnosis of suspected plague is made, the patient should be isolated, and local and state health departments should be notified. Confirmatory laboratory work should be initiated, including blood cultures and examination of lymph node specimens if possible. Drug therapy should begin as soon as possible after the laboratory specimens are taken. The drugs of choice are streptomycin or gentamycin, hut a number of other antibiotics are also effective. 

Antibiotics may be taken in the event of exposure to the bites of wild rodent fleas during an outbreak or to the tissues or fluids of a plague-infected animal. Preventive therapy is also... 

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