Efficacy of #Ceftriaxone, Cefepime, #Doxycycline, #Ciprofloxacin, and Combination #Therapy for #Vibrio vulnificus #Foodborne #Septicemia (AAC, abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Efficacy of Ceftriaxone, Cefepime, Doxycycline, Ciprofloxacin, and Combination Therapy for Vibrio vulnificus Foodborne Septicemia

Sonya A. Trinh a, Hannah E. Gavin b and Karla J. F. Satchell b*

Author Affiliations: a Northwestern University Feinberg School of Medicine, Department of Medicine, Division of Infectious Diseases, 645 North Michigan Avenue, Suite 900, Chicago, Illinois, 60611, USA; b Northwestern University Feinberg School of Medicine, Department of Microbiology-Immunology, 303 East Chicago Avenue, Ward 6-225, Chicago, Illinois, 60611, USA

 

ABSTRACT

Vibrio vulnificus foodborne infections have higher rates of sepsis and mortality compared to wound infections; however, antibiotic efficacy studies have not been performed in foodborne infection models. The efficacy of ceftriaxone, cefepime, doxycycline, ciprofloxacin, and combination therapy was assessed in a V. vulnificus intestinal infection in mice to model foodborne infections. Consistent with prior studies of cefotaxime, cefepime was synergistic with doxycycline and ciprofloxacin in vitro; combination therapy significantly decreased bacterial growth by ≥2log10 compared to antibiotic monotherapy (p<0.01). In vivo, survival in the ceftriaxone (50%), doxycycline (79%), and ciprofloxacin (80%) groups were significantly higher than the control group (0%) (p<0.0001). Survival with ceftriaxone-doxycycline (91%) and ceftriaxone-ciprofloxacin (100%) therapy was significantly higher than with ceftriaxone (50%) (p≤0.05). Survival with cefepime-doxycycline (96%) and cefepime-ciprofloxacin (90%) therapy was significantly higher than with cefepime (20%) (p<0.001). There was no difference in survival between the combination therapy groups. Thus, we conclude that combination therapy was the most effective treatment for V. vulnificus foodborne septicemia. In a septic patient with a recent ingestion of raw seafood, cefepime in combination with doxycycline or ciprofloxacin should be initiated for coverage of resistant Gram-negative organisms and V. vulnificus while awaiting a microbiological diagnosis. Once a diagnosis of V. vulnificus foodborne septicemia is established, treatment can be safely transitioned to ceftriaxone in combination with doxycycline or ciprofloxacin.

 

FOOTNOTES

*Corresponding Author: Karla J. F. Satchell, Northwestern University Feinberg School of Medicine, Department of Microbiology-Immunology, 303 East Chicago Avenue, Ward 6-205, Chicago, Illinois, 60611, USA, k-satchell@northwestern.edu

Copyright © 2017 American Society for Microbiology. All Rights Reserved.

Keywords: Antibiotics; Vibrio Vulnificus; Ceftriaxone; Ciprofloxacin; Cefepime; Doxycycline.

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Successful #Treatment of #Human #Plague with Oral #Ciprofloxacin (@CDC_EIDjournal, abstract)

[Source: US Centers for Disease Control and Prevention  (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 23, Number 3—March 2017 / Research Letter

Successful Treatment of Human Plague with Oral Ciprofloxacin

Titus Apangu, Kevin Griffith1, Janet Abaru, Gordian Candini, Harriet Apio, Felix Okoth, Robert Okello, John Kaggwa, Sarah Acayo, Geoffrey Ezama, Brook Yockey, Christopher Sexton, Martin Schriefer, Edward Katongole Mbidde, and Paul Mead

Author affiliations: Uganda Virus Research Institute, Entebbe, Uganda (T. Apangu, J. Abaru, G. Candini, H. Apio, F. Okoth, R. Okello, J. Kaggwa, S. Acayo, G. Ezama, E.K. Mbidde); Centers for Disease Control and Prevention, Fort Collins, Colorado, USA (K. Griffith, B. Yockey, C. Sexton, M. Schriefer, P. Mead)

 

Abstract

The US Food and Drug Administration recently approved ciprofloxacin for treatment of plague (Yersina pestis infection) based on animal studies. Published evidence of efficacy in humans is sparse. We report 5 cases of culture-confirmed human plague treated successfully with oral ciprofloxacin, including 1 case of pneumonic plague.

Keywords: Yersinia Pestis; Plague; Ciprofloxacin.

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