Yersinia Enterocolitica Medication

Updated: Oct 20, 2015
  • Author: Zartash Zafar Khan, MD, FACP; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
  • Print
Medication

Medication Summary

Treatment of Y enterocolitica infection is usually supportive and directed at maintaining euvolemia. Antibiotics may be used in some cases. Septicemia carries a high mortality rate and should therefore be treated with antibiotics. Uncomplicated cases Y enterocolitica diarrhea usually resolve on their own without antibiotic treatment. However, in more severe or complicated infections, antibiotics may be useful.

Y enterocolitica is usually susceptible in vitro to aminoglycosides, chloramphenicol, tetracycline, trimethoprim-sulfamethoxazole (TMP-SMZ), piperacillin, ciprofloxacin, and third-generation cephalosporins. Isolates are often resistant to penicillin, ampicillin, and first-generation cephalosporins, as the organism often produces beta-lactamase. Clinical failure with cefotaxime has been reported. [54] Resistance to macrolides and fluoroquinolones is also sporadically reported. [55]

Clinically, Y enterocolitica infection responds well to aminoglycosides, TMP-SMZ, ciprofloxacin, and doxycycline.

Antimotility agents are contraindicated in the treatment of Y enterocolitica infection because of the increased risk of invasion.

Next:

Antibiotics, Other

Class Summary

The value of antibiotic therapy in uncomplicated acute colitis and mesenteric adenitis is not established. Antibiotic treatment may be required in patients with septicemia, with focal extraintestinal manifestations, and in immunocompromised patients with enterocolitis.

Ciprofloxacin (Cipro)

The bactericidal agent ciprofloxacin is a second-generation quinolone. It acts by interfering with DNA gyrase, by inhibiting the relaxation of supercoiled DNA, and by promoting the breakage of double-stranded DNA. Ciprofloxacin is highly active against gram-negative and gram-positive organisms.

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

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

The combination antibiotic TMP-SMZ inhibits bacterial growth by inhibiting the synthesis of dihydrofolic acid. It is not helpful in cases of uncomplicated gastroenteritis.

Ceftriaxone (Rocephin)

Ceftriaxone is a third-generation cephalosporin with gram-negative activity.

Gentamicin

Gentamicin is an aminoglycoside that is bactericidal for susceptible gram-negative organisms. This agent is not helpful for uncomplicated gastroenteritis.

Cefotaxime (Claforan)

Cefotaxime is a third-generation cephalosporin with a gram-negative spectrum. It has lower efficacy against gram-positive organisms. This agent is not helpful for uncomplicated gastroenteritis.

Tetracycline

Tetracycline treats gram-positive and gram-negative organisms, as well as mycoplasmal, chlamydial, and rickettsial infections. It inhibits bacterial protein synthesis by binding with the 30S and possibly 50S ribosomal subunit(s).

Chloramphenicol

Chloramphenicol binds to 50S bacterial-ribosomal subunits and inhibits bacterial growth by inhibiting protein synthesis. It is effective against gram-negative and gram-positive bacteria.

Piperacillin and tazobactam sodium (Zosyn)

This drug combination consists of an antipseudomonal penicillin plus a beta-lactamase inhibitor. It inhibits the biosynthesis of cell wall mucopeptide and is effective during the active multiplication stage.

Previous