Ciprofloxacin therapy for Mediterranean spotted fever

Raoult, Didier; Gallais, H; Micco, P. De; Casanova, Paul

doi:10.1128/aac.30.4.606

Cited by 63 publications

(22 citation statements)

References 4 publications

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“…The results obtained by the immunofluorescence assay are not consistent with clinical experience, suggesting that the method should be reconsidered. Patients suffering from Mediterranean spotted fever have been successfully treated with fluoroquinolones (4,8,13,19), and thus, fluoroquinolones may be considered a safe alternative to tetracyclines for the treatment of rickettsial diseases. During pregnancy and childhood, macrolide compounds may represent a safe alternative to doxycycline and fluoroquinolones.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Antibiotic Susceptibilities of Three Rickettsial Species Including Rickettsia felis by a Quantitative PCR DNA Assay

Rolain

Stuhl

Maurin

et al. 2002

Antimicrob Agents Chemother

114

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Rickettsiae grow only intracellularly, and the antibiotic susceptibilities of these bacteria have been assessed by either plaque, dye uptake, or immunofluorescence assays, which are time-consuming. We used a quantitative PCR (with the LightCycler instrument) to assess the levels of inhibition of Rickettisa felis, R. conorii, and R. typhi DNA synthesis in the presence of various antibiotics. We established the kinetics of rickettsial DNA during growth and showed that R. conorii grows more quickly than R. typhi in cell culture, with maximum replication occurring after 5 and 7 days, respectively. The MICs of the antibiotics tested for R. conorii and R. typhi by the quantitative PCR assay were similar to those previously obtained by plaque and dye uptake assays. We found that R. felis is susceptible to doxycycline, rifampin, thiamphenicol, and fluoroquinolones but not to gentamicin, erythromycin, amoxicillin, or trimethoprim-sulfamethoxazole. The resistance of this new species to erythromycin is consistent with its current taxonomic position within the spotted fever group. We believe that quantitative PCR could be used in the future to simplify and shorten antibiotic susceptibility assays of other rickettsiae and other strict intracellular pathogens.Rickettsiae are strict intracellular bacteria belonging to the alpha group of the class Proteobacteria (15). Rickettsioses are zoonoses that have geographical distributions similar to those of their vectors. The genus comprises the spotted fever group rickettsiae and the typhus group rickettsiae, which includes Rickettsia prowazekii, the agent of epidemic typhus, and R. typhi, the agent of murine typhus (16). Since they are obligate intracellular bacteria, in vitro studies of their susceptibilities to antibiotics necessitate the use of cell culture systems. Using the plaque assay and the dye uptake assay (18), we have now described the antibiotic susceptibilities of most of the rickettsiae with the exception of R. felis, which, until recently, was not available to us. The two assays depend on the induction of cytopathic effects and plaque formation in cell cultures by the rickettsiae, but some rickettsiae do not normally cause cytopathic effects in primary cultures (18). Recently, Ives et al.(5-7) described a new assay that uses immunofluorescence staining, which avoids the problem of a lack of cytopathic effects. A lack of cytopathic effects occurs with R. felis, the agent of flea-borne spotted fever, which we have now isolated and cultured in a Xenopus laevis cell line (XTC-2 cells) (14) and in Vero cells. To determine the antibiotic susceptibility of this species we developed an original antibiotic assay using PCR with the LightCycler instrument. It is a new, real-time PCR technique which has been used to diagnose several bacterial infections (3) but which has not been used to determine antibiotic susceptibilities. The technique combines PCR amplification and detection of products in a single optically clear glass capillary tube, which enables rapid temperature transi...

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Section: Discussionmentioning

confidence: 99%

Evaluation of Antibiotic Susceptibilities of Three Rickettsial Species Including Rickettsia felis by a Quantitative PCR DNA Assay

Rolain

Stuhl

Maurin

et al. 2002

Antimicrob Agents Chemother

114

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“…These results are slightly better than those obtained with other fluoroquinolones: the MICs of ciprofloxacin are 0.25 ,ug/ml for R. conorii and 1 ,ug/ml for R. rickettsii (16), the MICs of pefloxacin are 0.5 ,ug/ml for R. conorii and 1 ,ug/ml for R. rickettsii (18), and the MICs of ofloxacin are 1 ,ug/ml for both rickettsiae (20). Ciprofloxacin (14) and pefloxacin and ofloxacin (3) have been successfully used in treating Mediterranean spotted fever. However, the potential toxicities of fluoroquinolones limit their use during pregnancy and childhood.…”

Section: Discussionmentioning

confidence: 99%

“…The mainstay of treatment is chloramphenicol or tetracycline and its analogs (23,27). The fluoroquinolones also have been successfully used for treating Mediterranean spotted fever patients (3,14). Because of their potential adverse effects, all of these compounds are not recommended during pregnancy and childhood.…”

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confidence: 99%

In vitro susceptibilities of Coxiella burnetii, Rickettsia rickettsii, and Rickettsia conorii to the fluoroquinolone sparfloxacin

Raoult¹,

Brès²,

Drancourt³

et al. 1991

Antimicrob Agents Chemother

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In vitro susceptibilities of Rickettsia nckettsu, Rickettsia conoru, and CoxieUa burneti to the new fluoroquinolone sparfloxacin (AT4140; RP 64206) were determined. Plaque and dye uptake assays were used to measure the MICs against R. rickettsii and R. conoru. The susceptibifities of C. burnetii Nine Mile and Q 212 were determined in two acute-infection models and In two chroni-infection models. The MICs were 0.125 to 0.25 ,ug/ml for R. ,ickeffsu and 0.25 to 0.5 pg/ml for R. conoriu. Sparfloxacin (1 pg/ml) cured cells recently infected with C. burnetW Nine Mile and Q 212 within 4 to 9 days and cured multiplying, persistently infected cels within 10 days, As prevousl described with other fluoroquinolones (D. Raoult, M. Drancourt, and G. Vestris, Antimicrob. Agents Chemother. 34:1512Chemother. 34: -1514Chemother. 34: , 1990, sparfRoxacin failed to cure cells persistently infected with C. burnelii and blocked from dividing with cycloheximide. As determined by the dye uptake assay, no cellular toxicity was noted with spariloxacin at up to 128 gAg/mI. These results are consistent with those previously obtained with fluoroquinolones (D. Raoult, M. Yeaman, and 0. Baca, Rev. Infect. Dis. ll[Suppl. 5]:S986, 1989), although sparfloxacin may be slightly more active.Rickettsia rickettsii and Rickettsia conorii are the etiologic agents of Rocky Mountain spotted fever and Mediterranean spotted fever, respectively. These bacteria are antigenically (9) and genetically closely related and share the morphological characteristics and biochemical compositions of gramnegative bacteria. Both rickettsiae are strict intracellular pathogens, living free in the cytoplasm of infected host cells.

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“…The main clinical signs and symptoms of MSF are: a skin eschar (tache noire) at the site of tick bite, fever and flu-like manifestations as headache, adynamia, anorexia, myalgia, etc., emerging 3-5 days before appearing of maculopapular rash involving the trunk and extremities, non-sparing the hands and feet. MSF has long been considered a benign disease, however "malignant" forms including severe complications with lethal outcome have been observed [2,3].…”

Section: Introductionmentioning

confidence: 99%

Hemorrhagic-Necrotizing Pancreatitis – An Unusual Complication of Mediterranean Spotted Fever

Baltadzhiev¹,

Popivanova²,

Zaprianov³

2017

IOSR JDMS

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Ciprofloxacin therapy for Mediterranean spotted fever

Cited by 63 publications

References 4 publications

Evaluation of Antibiotic Susceptibilities of Three Rickettsial Species Including Rickettsia felis by a Quantitative PCR DNA Assay

Evaluation of Antibiotic Susceptibilities of Three Rickettsial Species Including Rickettsia felis by a Quantitative PCR DNA Assay

In vitro susceptibilities of Coxiella burnetii, Rickettsia rickettsii, and Rickettsia conorii to the fluoroquinolone sparfloxacin

Hemorrhagic-Necrotizing Pancreatitis – An Unusual Complication of Mediterranean Spotted Fever

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