Evaluation of ciprofloxacin and doxycycline in the treatment of mediterranean spotted fever

Abstract

A comparison was made of the results obtained with ciprofloxacin (750 mg/12 h) and doxycycline (100 mg/12 h), both administered p.o. for one week, in 34 and 36 patients respectively with Mediterranean spotted fever. Apyrexia was achieved after 50.1 +/- 34.2 h (mean +/- SD) of antibiotic therapy in the group of patients treated with ciprofloxacin and in 55.2 +/- 23.3 h in the group treated with doxycycline (no significant statistical differences). Resolution of the remaining signs and symptoms of the disease was achieved faster with ciprofloxacin. Both therapeutic regimens were effective and safe. Although more expensive than doxycycline, ciprofloxacin is a bactericidal compound which is better tolerated and has a lower risk of toxicity and of development of resistance. It can be considered, together with doxycycline, as an antibiotic of first choice in the treatment of Mediterranean spotted fever.

In Vitro Susceptibilities of 27 Rickettsiae to 13 Antimicrobials

“…Our results show that fluoroquinolones are very effective against rickettsiae and confirm previous experiments with R. rickettsii and R. conorii (13,21,24,26,30). Patients suffering from Mediterranean spotted fever have been successfully treated with ciprofloxacin (10,25,36), ofloxacin (7), and pefloxacin (14). Fluoroquinolones may be considered a safe alternative to tetracyclines for the treatment of rickettsial diseases.…”

Mediterranean spotted fever: a report of 200 cases in Tunisia

“…A single dose of doxycycline (200 mg) has been shown to be sufficient for MSF [3]. Efficacy of 7 days of ciprofloxacin has been reported [4]. In our study, 3 days of this antibiotic was also sufficient to treat MSF.…”

Tick-Borne Rickettsioses around the World: Emerging Diseases Challenging Old Concepts

“…Azithromycin seems to be of particular interest, as it is administered once a day and presents a shorter duration of therapy (3 days, compared to 7 days with clarithromycin). Some fluoroquinolones may have efficacy against spotted fever rickettsiae, although these data are largely anecdotal and require careful clinical evaluation (227,290,298,299).…”