Antibiotic therapy for acute Q fever in The Netherlands in 2007 and 2008 and its relation to hospitalization

Abstract

Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. SUMMARYData about the effectiveness of different antibiotic regimens for the treatment of acute Q fever from clinical studies is scarce. We analysed the antibiotic treatment regimens of acute Q fever patients in 2007 and 2008 in The Netherlands and assessed whether hospitalization after a minimum of 2 days antibiotic therapy was related to the initial antibiotic therapy. Clinical data on antibiotic treatment and risk factors of acute Q fever patients were obtained from general practitioner medical records and self-reported by patients. For the 438 study patients, doxycycline was the most commonly prescribed initial antibiotic in both study years. After adjustments for confounding factors, doxycycline (200 mg/day), moxifloxacin, as well as other possibly effective antibiotics [including other new fluoroquinolones and doxycycline (100 mg/day)] showed significant lower risks for hospitalization compared to b-lactam antibiotics and azithromycin (reference group), with the lowest risk for doxycycline (200 mg/day) (odds ratio 0 . 04, 95 % confidence interval 0 . 01-0 . 22). These data support current guidelines that recommend doxycycline as the first choice antibiotic for treating acute Q fever.

Clinician Assessment forCoxiella burnetiiInfection in Hospitalized Patients with Potentially Compatible Illnesses During Q Fever Outbreaks and Following a Health Alert, Montana, 2011

“…If doxycycline is contraindicated, then an alternative antibiotic may be used, including trimethoprim-sulfamethoxazole, fluoroquinolones, and azithromycin, although these antibiotics have lower efficacy for treating Q fever (Dijkstra et al 2011). Excluding the 1 patient in this study who was tested for Q fever and treated with doxycycline, only 2 patients received doxycycline.…”

Etiologies of Illness Among Patients Meeting Integrated Management of Adolescent and Adult Illness District Clinician Manual Criteria for Severe Infections in Northern Tanzania: Implications for Empiric Antimicrobial Therapy

“…[31][32][33] The potential use of the three IMAIrecommended macrolides was not assessed for severe pneumonia cases associated with R. conorii or C. burnetii because of heterogeneous or limited data on macrolide therapy for these organisms. [34][35][36][37] Analysis of respiratory fluoroquinolones for participants with severe pneumonia was not undertaken as our laboratory did not perform antimicrobial susceptibility testing for these agents. In cases of S. pneumoniae infection detected by urine antigen testing, susceptibility to ceftriaxone, ampicillin, gentamicin, and erythromycin were extrapolated from antimicrobial susceptibility testing of S. pneumoniae bloodstream isolates from study participants.…”

Coxiella burnetii Infection in a Community Operating a Large-Scale Cow and Goat Dairy, Missouri, 2013

“…Acute Q fever is most often self-limited and is effectively treated with doxycycline. [1][2][3] A small percentage of those infected with C. burnetii (< 5%) may develop chronic Q fever. Chronic Q fever is a serious and potentially fatal infection that may manifest as endocarditis, chronic vascular infection, chronic hepatitis, or chronic pulmonary infection.…”