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 |
|