Mediterranean Spotted Fever Medication

  • Author: Jason F Okulicz, MD; Chief Editor: Michael Stuart Bronze, MD   more...
 
Updated: Nov 22, 2011
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity, to prevent complications, and to eradicate the infection. Patients with Mediterranean spotted fever typically improve within 24 hours after initiation of therapy, and a delay in response should cast doubt on the diagnosis.

Next

Antibiotics

Class Summary

Empiric antimicrobial therapy must be comprehensive and cover all likely pathogens in the context of this clinical setting.

In an analysis of risk factors for malignant Mediterranean spotted fever, researchers noted that fluoroquinolone may have a deleterious effect.[6]

View full drug information

Doxycycline (Vibramycin)

 

Tetracycline with broad spectrum of activity. Inhibits protein synthesis and thus bacterial growth by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria.

View full drug information

Ciprofloxacin (Cipro)

 

Fluoroquinolone with activity against most gram-negative organisms but no activity against Bacteroides fragilis. Inhibits bacterial DNA synthesis and consequently growth.

View full drug information

Levofloxacin (Levaquin)

 

Second-generation quinolone. Acts by interfering with DNA gyrase in bacterial cells. Bactericidal. Highly active against gram-negative and gram-positive organisms, including Pseudomonas aeruginosa.

View full drug information

Chloramphenicol (Chloromycetin)

 

Binds to 50S bacterial-ribosomal subunits and inhibits bacterial growth by inhibiting protein synthesis. Effective against gram-negative and gram-positive bacteria.

View full drug information

Azithromycin (Zithromax)

 

Acts by binding to 50S ribosomal subunit of susceptible microorganisms and blocks dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest.

View full drug information

Clarithromycin (Biaxin)

 

Semisynthetic macrolide antibiotic that reversibly binds to P site of 50S ribosomal subunit of susceptible organisms and may inhibit RNA-dependent protein synthesis by stimulating dissociation of peptidyl t-RNA from ribosomes, causing bacterial growth inhibition.

Previous
Proceed to Follow-up
 
 
Contributor Information and Disclosures
Author

Jason F Okulicz, MD  Assistant Professor of Medicine, Uniformed Services University of the Health Sciences; Staff, Infectious Disease Service, Brooke Army Medical Center

Jason F Okulicz, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Coauthor(s)

Mark S Rasnake, MD, FACP  Assistant Professor of Medicine, Program Director, Internal Medicine Residency, University of Tennessee Graduate School of Medicine; Consulting Staff, Department of Infectious Diseases, University of Tennessee Medical Center at Knoxville

Mark S Rasnake, MD, FACP is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Pierre A Dorsainvil, MD  Medical Director, HIV Specialist, Palm Beach County Main Detention Center; Consulting Staff, Department of Internal Medicine, Division of Infectious Diseases, Lake Ida Medical Center

Disclosure: Nothing to disclose.

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Joseph Richard Masci, MD  Professor of Medicine, Professor of Preventive Medicine, Mount Sinai School of Medicine; Director of Medicine, Elmhurst Hospital Center

Joseph Richard Masci, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, Association of Professors of Medicine, and Royal Society of Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Thomas M Kerkering, MD  Chief of Infectious Diseases, Virginia Tech Carilion School of Medicine

Thomas M Kerkering, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Public Health Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Medical Society of Virginia, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD  Professor, Stewart G Wolf Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

References

  1. Popivanova NI, Murdjeva MA, Baltadzhiev IG, Haydushka IA. Dynamics in serum cytokine responses during acute and convalescent stages of Mediterranean spotted fever. Folia Med (Plovdiv). Apr-Jun 2011;53(2):36-43. [Medline].

  2. Popivanova N, Hristova D, Hadjipetrova E. Guillain-Barré polyneuropathy associated with mediterranean spotted fever: case report. Clin Infect Dis. Dec 1998;27(6):1549. [Medline].

  3. Leone S, De Marco M, Ghirga P, et al. Retinopathy in Rickettsia conorii Infection: Case Report in an Immunocompetent Host. Infection. Aug 2008;36(4):384-6. [Medline].

  4. Tsiachris D, Deutsch M, Vassilopoulos D, et al. Sensorineural hearing loss complicating severe rickettsial diseases: report of two cases. J Infect. Jan 2008;56(1):74-6. [Medline].

  5. Giulieri S, Jaton K, Cometta A, Trellu LT, Greub G. Development of a duplex real-time PCR for the detection of Rickettsia spp. and typhus group rickettsia in clinical samples. FEMS Immunol Med Microbiol. Nov 21 2011;[Medline].

  6. Botelho-Nevers E, Rovery C, Richet H, Raoult D. Analysis of risk factors for malignant Mediterranean spotted fever indicates that fluoroquinolone treatment has a deleterious effect. J Antimicrob Chemother. Aug 2011;66(8):1821-30. [Medline].

  7. Aharonowitz G, Koton S, Segal S, et al. Epidemiological characteristics of spotted fever in Israel over 26 years. Clin Infect Dis. Nov 1999;29(5):1321-2. [Medline].

  8. Anton E, Font B, Munoz T, et al. Clinical and laboratory characteristics of 144 patients with mediterranean spotted fever. Eur J Clin Microbiol Infect Dis. Feb 2003;22(2):126-8. [Medline].

  9. Burgert SJ. Clinical manifestations of African tick-bite fever in the returning traveler. Infect Dis Clin Pract. 2000;9:137-8.

  10. Cascio A, Colomba C, Antinori S, et al. Clarithromycin versus azithromycin in the treatment of Mediterranean spotted fever in children: a randomized controlled trial. Clin Infect Dis. Jan 15 2002;34(2):154-8. [Medline].

  11. Elghetany MT, Walker DH. Hemostatic changes in Rocky Mountain spotted fever and Mediterranean spotted fever. Am J Clin Pathol. Aug 1999;112(2):159-68. [Medline].

  12. Jenkins DR, Rees JC, Pollitt C, et al. Mediterranean spotted fever mimicking Kawasaki disease. BMJ. Mar 1 1997;314(7081):655-6. [Medline].

  13. Jensenius M, Fournier PE, Raoult D. Tick-borne rickettsioses in international travellers. Int J Infect Dis. May 2004;8(3):139-46. [Medline].

  14. La Scola B, Raoult D. Diagnosis of Mediterranean spotted fever by cultivation of Rickettsia conorii from blood and skin samples using the centrifugation-shell vial technique and by detection of R. conorii in circulating endothelial cells: a 6-year follow-up. J Clin Microbiol. Nov 1996;34(11):2722-7. [Medline].

  15. Raoult D, Soulayrol L, Toga B, et al. Babesiosis, pentamidine, and cotrimoxazole. Ann Intern Med. Dec 1987;107(6):944. [Medline].

  16. Rolain JM, Jensenius M, Raoult D. Rickettsial infections--a threat to travellers?. Curr Opin Infect Dis. Oct 2004;17(5):433-7. [Medline].

  17. Shazberg G, Moise J, Terespolsky N, et al. Family outbreak of Rickettsia conorii infection. Emerg Infect Dis. Sep-Oct 1999;5(5):723-4. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.