Managing Q Fever during Pregnancy: The Benefits of Long-Term Cotrimoxazole Therapy

Carcopino, Xavier; Raoult, Didier; Bretelle, Florence; Boubli, L.; Stein, Andréas

doi:10.1086/520661

Cited by 134 publications

(202 citation statements)

References 33 publications

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“…Other fluoroquinolones such as gatifloxacin were not available in The Netherlands. Co-trimoxazole is recommended as treatment during pregnancy [12]. For azithromycin, an in vitro study suggested an unfavourable minimum inhibitory concentration [13].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2010

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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.

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Section: Discussionmentioning

confidence: 99%

“…For a number of antibiotics, only retrospective analyses, case reports or in vitro data are available [6][7][8][9][10][11][12][13][14]. Some of these studies show contradictory results.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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“…This description also applies to Figures 2 and 3. dosage of 100 mg of doxycycline 2×/day for 5 days, beginning 8-12 days postexposure. As doxycycline is generally not recommended for pregnant women, we assumed a PEP dosage of 160 mg/800 mg TMP-SMX 2×/day for the duration of the pregnancy, starting 8-12 days postexposure (21).…”

Section: Interventionsmentioning

confidence: 99%

Prophylaxis after Exposure toCoxiella burnetii

Moodie¹,

Thompson²,

Meltzer³

et al. 2008

Emerg. Infect. Dis.

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Coxiella burnetii is a category B bioterrorism agent. We numerically evaluated the risks and benefi ts from postexposure prophylaxis (PEP) after an intentional release of C. burnetii to the general population, pregnant women, and other high-risk populations. For each group, we constructed a decision tree to estimate illness and deaths averted by use of PEP/100,000 population. We calculated the threshold points at which the number of PEP-related adverse events was equal to the cases averted. PEP was defi ned as doxycycline (100 mg 2×/day for 5 days), except for pregnant women, where we assumed a PEP of trimethoprimsulfamethoxazole (160 mg/800 mg 2×/day) for the duration of the pregnancy. PEP would begin 8-12 days postexposure. On the basis of upper-bound probability estimates of PEP-related adverse events for doxycycline, we concluded that the risk for Q fever illness outweighs the risk for antimicrobial drug-related adverse events when the probability of C. burnetii exposure is >7% (pregnant women using trimethoprim-sulfamethoxazole = 16%).

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“…Acute Q fever may reactivate during pregnancy or may progress to chronicity, causing recurrent episodes of premature birth. The risk of developing chronic Q fever after acute infection is much higher in pregnant women than in the general population [6].…”

Section: Introductionmentioning

confidence: 99%

A preliminary report of relationship between abortion and Q fever in Central Black Sea Region Turkish woman

Günal¹,

Demirtürk²,

Barut³

et al. 2014

Cumhuriyet Med J

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Aim. Q fever, which is a zoonosis caused by Coxiella burnetii, may result in abortions in infected animals and pregnant women. In our study, we searched the association between Q fever serology and abortion in a region where Q fever is endemic. Method. This study was conducted in Gaziosmanpaşa University Hospital between March and May 2012. A total of 100 women, from these, 64 had a history of spontaneus abortion (cases) and 36 had live births with no complicated obstetrics history or complicated partum (controls), enrolled in the study. Both groups were compared according to where they live, underlying diseases, contact with farm animals or pets and village connectivity. Results. IgG seroprevalence of Coxiella in our study group with the history of abortion was 15.6%, and 11.1% in the control group (p>0.05). When case and control groups were compared, the frequency of inhabitants of the village (p=0.012), subjects who had contact with farm animals [p=0.026, especially cattle (p=0.013)] or domestic animals (p=0.018) in case group were more common than the control group. When all the samples were analyzed, it was seen that the only significant variable affecting Coxiella IgG seropositivity was residency in rural area or visiting rural area (p=0.018). Conclusions. We have found that the relation between abortion and Q fever infection was not statistically significant. On this issue, multicenter studies which have the higher number of samples are needed in our country.Keywords: Q fever, spontaneous abortions, endemic region Özet Amaç. Q ateşi Coxiella burnetii tarafından oluşturulan bir zoonozdur. Q ateşi gebe hayvanlarda ve gebe kadınlarda abortusa neden olabilir. Biz bu çalışmamızda Q ateşi için endemik bir bölgede Q ateşi seropozitifliği ve abortus arasındaki ilişkiyi araştırdık. Yöntem. Bu çalışma Gaziosmanpaşa Üniversitesi Hastanesinde Mart 2012-Mayıs 2012 tarihleri arasında yürütüldü. Çalışmaya 18 yaş üzerinde toplam 100 kadın dahil edildi. Bunların 64'ünün spontan abortus hikayesi pozitif (vaka grubu) iken 36'sının hiç komplikasyonlu gebelik veya doğum hikayesi yoktu (kontrol grubu). Her iki grup yaşadıkları yer, altta yatan hastalıkları, çiflik hayvanı veya evcil hayvanlarla temas ve köy yaşantısı ile ilişki açısından karşılaştırıldı. Bulgular. Vaka grubunda Coxiella lgG seropozitifliği %15,6 çıkarken kontrol grubunda %11,1 olarak saptandı, bu fark istatistiksel olarak anlamlı değildi (p>0,05). Vaka grubu kontrol grubuyla karşılaştırıldığında köyde yaşama (p=0,012), çiftlik hayvanları ile temas [p=0,026; özellikle koyun (p=0,013)] veya evcil hayvanlarla temas (p=0,018) vaka grubunda anlamlı derecede daha yüksek saptandı. Tüm örnekler analiz edildiğinde Coxiella IgG seropozitifliğini etkileyen en önemli değişken kırsal alanda yaşama veya kırsal yaşamla ilişkili olma olarak bulundu (p=0,018). Sonuç. Çalışmanın sonucunda Q ateşi ile abortus arasında anlamlı bir ilişki bulunamadı. Bu çalışma bu konuyla ilgili ülkemizde yapılmış ilk çalışma olmakla birlikte çok merkezli ve yüksek örneklem sayılı çalışmal...

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Managing Q Fever during Pregnancy: The Benefits of Long-Term Cotrimoxazole Therapy

Cited by 134 publications

References 33 publications

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

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

Prophylaxis after Exposure toCoxiella burnetii

A preliminary report of relationship between abortion and Q fever in Central Black Sea Region Turkish woman

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