Table 1. In vitro antibiotic susceptibility of R. prowazekii, Breinl (ATCC VR-142) and

    Madrid E (ATCC VR-233) strains. The minimum antibiotic doses or MAD (mg/egg)

    allowing a DMST > 2.5 days in the embryonated egg model, and MICs (mg/L) obtained

    in cell culture models are presented.

 

Antibiotics

embryonated eggs MAD (mg/egg)

cell cultures MICs (mg/L)

Strain

References

Penicillin G

162

128

Breinl

Breinl

(24)

(32)

Amoxicillin

 

128

Breinl

(32)

Streptomycin

10,000

 

Breinl

(34)

Gentamicin

 

16

Breinl

(32)

Chloramphenicol

 

1

Breinl

(47)

Thiamphenicol

 

1

Breinl

(32)

Chlortetracycline

129

 

Breinl

(24)

Oxytetracycline

30

10

 

Breinl

Breinl

(36)

(24)

Tetracycline

 

0.01-0.1

Breinl

(47)

Doxycycline

 

0.1

Breinl

(47)

Minocycline

 

0.01-0.1

Breinl

(47)

Rifampin

 

0.008

Breinl

(47)

Sulfamethoxazole

 

>4

Breinl

(32)

Erythromycin

15

 

0.06

2

Breinl

Breinl

Madrid E

(24)

(47)

(11)

Dirithromycin

 

16

Madrid E

(11)

Roxithromycin

 

1

Madrid E

(11)

Azithromycin

 

0.25

Madrid E

(11)

Clarithromycin

 

0.125

1

Madrid E

Breinl

(11)

(32)

Josamycin

 

1

Breinl

(32)

Telithromycin

 

0.5

Breinl

(31)

Pefloxacin

 

1

Breinl

(32)

Ciprofloxacin

 

0.5

2.8

Breinl

Breinl

(32)

(32)

Ofloxacin

 

1

9

Breinl

Madrid E

(32)

(12)

Levofloxacin

 

7.4

Madrid E

(12)

Sparfloxacin

 

1

Madrid E

(12)

 


 

Table 2. Recommendations for antibiotic treatment of R. prowazekii infections.

 

Condition

antibiotic

dose

duration

References

epidemic typhus in adult and in child > 8 years

and

Brill Zinsser disease

1. doxycycline

100 mg b.i.d. p.o.

(i.v. in case of severe disease)

7-14 days

(9, 13, 16, 35)

2. doxycycline

100-200 mg p.o.

single dose

(9, 10, 13, 27)

3. chloramphenicol

500mg every 6 hours

7-14 days

(9, 13)

epidemic situation

doxycycline to all suspected cases

100 mg b.i.d. p.o.

2 days

(29, 30)

child of less than 8 years old

1. doxycycline

100-200 mg p.o.

single dose

 

2. chloramphenicol

50mg/Kg/day in divided doses every 6 hours

7-14 days