Typhus medical therapy

Typhus Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Typhus from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Typhus medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Typhus medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Typhus medical therapy

CDC on Typhus medical therapy

Typhus medical therapy in the news

Blogs on Typhus medical therapy

Directions to Hospitals Treating Typhus

Risk calculators and risk factors for Typhus medical therapy

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

## Overview

[edit | edit source]

The mainstay of therapy for rickettsial illnesses is antimicrobial therapy. Doxycycline is the drug of choice for louse borne and murine typhus.

## Medical Therapy

[edit | edit source]

### Pharmacotherapy

[edit | edit source]

### Typhus, louse-borne

[edit | edit source]

* Louse born typhus, Rickettsia prowazekii (epidemic typhus, sylvatic typhus and Brill–Zinsser typhus [1]

* Pathogen-directed antimicrobial therapy

* In adults

* Preferred regimen (1): Doxycycline 200 mg PO for 5 days or 2-3 days after defervescence
* Preferred regimen (2): Doxycycline 100-200 mg PO single dose in outbreak situation
* Alternative regimen: Chloramphenicol 60 to 75 mg/kg/day PO in four divided doses

* In children

* Preferred regimen (1): Doxycycline 100-200 mg PO single dose

* In pregnant women

* Preferred regimen: Doxycycline 100-200 mg PO single dose

### Typhus, murine

[edit | edit source]

* Murine typhus,Rickettsia typhi (flea-borne infection) [1]

* Pathogen-directed antimicrobial therapy

* 1\. Adults

* Preferred regimen : Doxycycline 100 mg PO bid continued for 3 days after the symptoms have resolved, Doxycycline 100-200 mg, PO single dose
* Alternative regimen (1): Oxacillin 2-12 g/24 hr IV q4-6h IV (maximum dose: 12 g/24)
* Alternative regimen (2): Chloramphenicol 60 to 75 mg/kg/day PO in qid

* 2\. Children

* Preferred regimen: Doxycycline 100-200 mg, PO for 3-7 days
* Alternative regimen: Chloramphenicol 50-75 mg/kg/24 hr IV/PO q 6-8 hr

* 3\. Pregnant women

* Preferred regimen: Doxycycline 100-200 mg, PO single dose ( late trimester)
* Alternative regimen (1): Erythromycin Base: 333 mg PO tid or estolate/stearate/ base: 250-500 mg PO qid
* Alternative regimen (2): Chloramphenicol 50 mg/kg/24 hr IV/PO q6h (maximum dose: 4 g/24 hr) (early trimester: first and second trimesters)

### Typhus, scrub

[edit | edit source]

* Scrub typhus, Orientia tsutsugamushi (previously called Rickettsia tsutsugamushi- mite-borne infectious disease) [2]

* Pathogen-directed antimicrobial therapy

* Preferred regimen (1): Doxycycline 100 mg PO/IV q12h for 3 days
* Preferred regimen (2): Chloramphenicol 500 mg PO/IV q6h
* Alternative regimen: Azithromycin 500 mg PO day 1 followed by 250 mg for 4 days

## References

[edit | edit source]

1. ↑ 1.0 1.1 Botelho-Nevers E, Socolovschi C, Raoult D, Parola P (2012). "Treatment of Rickettsia spp. infections: a review". Expert Rev Anti Infect Ther. 10 (12): 1425–37. doi:10.1586/eri.12.139. PMID 23253320.CS1 maint: Multiple names: authors list (link)
2. ↑ Panpanich R, Garner P (2002). "Antibiotics for treating scrub typhus". Cochrane Database Syst Rev (3): CD002150. doi:10.1002/14651858.CD002150. PMID 12137646.

Template:WH Template:WS