News & Perspective
Drugs & Diseases
CME & Education
Academy
Video
Decision Point
Edition: English

Medscape

English
Deutsch
Español
Français
Português
UKNew

Univadis

Sign Up It's Free!
English Edition

Medscape

Univadis

    X
    Univadis from Medscape

    No Results

      News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
      Drugs & Diseases > Infectious Diseases

      Bartonellosis (Bartonella Infection) Medication

      Updated: Mar 09, 2022
      • Author: Kassem A Hammoud, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
      • Print
      Medication

      Medication Summary

      Bartonellosis is generally treated with macrolides, tetracyclines, aminoglycosides, or chloramphenicol. Chloramphenicol is not usually used to treat either B henselae or B quintana infection, although it has been used to treat B bacilliformis infection. Chloramphenicol primarily has been used to treat Oroya fever.

      Duration of therapy is commonly at least 3 weeks. Patients should be monitored for evidence of response and drug toxicity. Because these infections often fail to respond to therapy or patients experience relapse later, switching to antibiotics from other classes (eg, erythromycin, clarithromycin, azithromycin, trimethoprim and sulfamethoxazole, or ciprofloxacin) with or without rifampin may be needed. A combination with Gentamicin may also be needed if lack of response to therapy or evidence of endocarditis.

      Longer duration of therapy, from 3 weeks to several months, may be required for patients who have peliosis hepatis or disseminated disease, including bacteremia.

      A culture-negative endocarditis treatment regimen should include an aminoglycoside (gentamicin) for 2 weeks and ceftriaxone with or without doxycycline for 6 weeks.

      If bartonellosis is proven, the guidelines recommend using a regimen consisting of doxycycline for at least 6 weeks plus gentamicin (1 mg/kg IV q8h for 14 d). A 2003 study by Raoult et al showed that at least 14 days of aminoglycosides was associated with improved survival. [53]  

      Valve replacement is required in at least 50% of cases, but overall prognosis is good, with survival rates of 80%.

      Patients in the acute phase of Carrión disease should receive ciprofloxacin and, alternatively, chloramphenicol plus penicillin G. Patients in the eruptive phase of the disease should receive rifampin and, alternatively, azithromycin or erythromycin.

      Next:

      Antibiotics

      Class Summary

      Therapy must be comprehensive and cover all likely pathogens in the context of the clinical setting.

      Doxycycline (Vibramycin)

      Inhibits protein synthesis and bacterial growth by binding to 30S, and possibly 50S, ribosomal subunits of susceptible bacteria. For B quintana infection, bacillary angiomatosis, peliosis hepatitis, and AIDS.

      Erythromycin (EES, E-Mycin, Eryc)

      Inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest.

      Azithromycin (Zithromax)

      Treats mild-to-moderate microbial infections.

      Clarithromycin (Biaxin)

      Inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest.

      Ciprofloxacin (Cipro)

      Fluoroquinolone with activity against Pseudomonas species, streptococci, MRSA, Staphylococcus epidermidis, and most gram-negative organisms but no activity against anaerobes. Inhibits bacterial DNA synthesis and, consequently, growth.

      Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS, Septra, Septra DS)

      Inhibits bacterial growth by inhibiting synthesis of dihydrofolic acid.

      Chloramphenicol (Chloromycetin)

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

      Gentamicin (Garamycin)

      Aminoglycoside antibiotic for gram-negative coverage. Used in combination with both an agent against gram-positive organisms and another agent that covers anaerobes.

      Previous
      Questions
       
       
      Media Gallery
      of 0
      Find Us On
      About
      About Medscape Privacy Policy Editorial Policy Cookies Terms of Use Advertising Policy Help Center
      Membership
      Become a Member About You Professional Information Newsletters & Alerts Market Research
      App
      Medscape
      WebMD Network
      Medscape Live Events WebMD MedicineNet eMedicineHealth RxList WebMD Corporate Medscape UK
      Editions
      English Deutsch Español Français Português UK
      All material on this website is protected by copyright, Copyright © 1994-2023 by WebMD LLC. This website also contains material copyrighted by 3rd parties.