Rocky Mountain spotted fever, treatment

These antibiotics are effective in die treatment of infections caused by a wide range of gram-negative and gram-positive microorganisms. The tetracyclines are used in infections caused by Rickettsiae (Rocky Mountain spotted fever, typhus fever, and tick fevers). Tetracyclines are also used in situations in which penicillin is contraindicated, in the treatment of intestinal amebiasis, and in some skin and soft tissue infections. Oral... 

Respiratory, skin, and soft-tissue infections UTIs pelvic inflammatory disease (PID) brucellosis trachoma Rocky Mountain spotted fever typhus Q fever lickettsia severe acne (Adoxa) smallpox psittacosis ornithosis granuloma inguinale lymphogranuloma venereum intestinal amebiasis (adjunctive treatment) prevention of rheumatic fever ... 

Because of potential toxicity, bacterial resistance, and the availability of many other effective alternatives, chloramphenicol is rarely used. It may be considered for treatment of serious rickettsial infections such as typhus and Rocky Mountain spotted fever. It is an alternative to a B-lactam antibiotic for treatment of meningococcal meningitis occurring in patients who have major hypersensitivity reactions to penicillin or bacterial meningitis caused by penicillin-resistant strains of pneumococci. The dosage is 50-100 mg/kg/d in four divided doses. 

Although the clinical usefulness of tetracyclines is limited for most of the common microbial pathogens, they remain drugs of choice (or very effective alternative therapy) for a wide variety of infections caused by less common pathogens. These include brucellosis rickettsial infections such as Rocky Mountain spotted fever, typhus, and Q fever Mycoplasma pneumonia cholera plague Ureaplasma urethritis Chlamydia infections and Lyme disease. Oral doxycycline, 100 mg orally twice a day for 7 days, is a recommended treatment for chlamydial sexually transmitted disease. 

Clinical usage Tetracylines are effective for sexually transmitted diseases caused by chlamydia and syphilis. They are also commonly used for the treatment of community-acquired pneumonia, Lyme disease, and Rocky Mountain spotted fever, and in combination with other agents for Helicobacter pylori. 

Salmonella typhi, S, pneumoniae. B. J rugilix, and N. meningitidis. Because of its penetration into the central nervous sy.stcm, chloramphenicol is a particularly important alternative therapy for meningitis. It is not recommended for the treatment of urinary tract infections bccau.se, i to 10% of the unconjugated form is excreted in the urine. Chloramphenicol is also used fur the treatment of rickettsial infections, such as Rocky Mountain spotted fever. 

The American Academy of Pediatrics recommends treatment of young children with tetracyclines for serious infections (e.g.. Rocky Mountain spotted fever)... 

Tetracyclines are effective in the treatment of Rocky Mountain spotted fever, murine typhus, recrudescent epidemic typhus, scrub typhus, Q fever, lymphogranuloma venereum, psittacosis, tularemia, brucellosis, gonorrhea, certain urinary tract infections, granuloma inguinale, chancroid, syphilis, and disease due to Bacteroides and Clostridium. 

Tetracyclines usually are the preferred agents for the treatment of rickettsial diseases. In patients allergic to these drugs, in those with reduced renal function, in pregnant women, and in children <8 years of age who require prolonged or repeated courses of therapy, chloramphenicol may be the drug of choice. Rickettsial diseases, such as Rocky Mountain spotted fever, respond well to chloramphenicol. For adults, a dose of 50 mg/kg/day is recommended for all the rickettsial diseases. The daily dose of chloramphenicol for children with these diseases is 75 mg/kg, divided into equal portions and given every 6-8 hours. Therapy should be continued until the patient has improved and is afebrile for 24—48 hours. 

Antirickettsial. PABA is sometimes used in the treatment of certain rickettsial diseases—diseases in man and animals caused by microscopically small parasites of the genus Rickettsia, notably typhus and Rocky Mountain spotted fever. 

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