In vitro susceptibility of Coxiella burnetii to azithromycin, doxycycline, ciprofloxacin and a range of newer fluoroquinolones

Lever, Mark S.; Bewley, Kevin R.; Dowsett, Barry; Lloyd, Graham

doi:10.1016/j.ijantimicag.2004.05.001

Cited by 22 publications

(19 citation statements)

References 6 publications

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“…CFI is 0.363. 2 g/ml (14,33). Treatment of chronic Q fever endocarditis with doxycycline alone resulted in Ͼ50% mortality and frequent relapse and requires the addition of alkalinization agents, such as hydroxychloroquine (7,34).…”

Section: Norville Et Almentioning

confidence: 99%

“…Although ciprofloxacin is not commonly used to treat acute Q fever, it has been used to successfully treat Q fever endocarditis (35,36). In vitro, the MIC of ciprofloxacin is slightly higher than the MIC of doxycycline (1 to 4 g/ml), and resistance to fluoroquinolones has been observed in some clinical isolates of C. burnetii (14,33,36). To date, there is only one report evaluating antibiotic treatment in an animal model of Q fever (37).…”

Section: Norville Et Almentioning

confidence: 99%

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Efficacy of Liposome-Encapsulated Ciprofloxacin in a Murine Model of Q Fever

Norville

Hatch

Bewley

et al. 2014

Antimicrob Agents Chemother

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Encapsulation of antibiotics may improve treatment of intracellular infections by prolonging antibiotic release and improving antibiotic uptake into cells. In this study, liposome-encapsulated ciprofloxacin for inhalation (CFI) was evaluated as a postexposure therapeutic for the treatment of Coxiella burnetii, the causative agent of Q fever. Intranasal treatment of male A/Jola (A/J) mice with CFI (50 mg/kg of body weight) once daily for 7 days protected mice against weight loss and clinical signs following an aerosol challenge with C. burnetii. In comparison, mice treated twice daily with oral ciprofloxacin or doxycycline (50 mg/kg) or phosphate-buffered saline (PBS) lost 15 to 20% body weight and exhibited ruffled fur, arched backs, and dehydration. Mice were culled at day 14 postchallenge. The weights and bacterial burdens of organs were determined. Mice treated with CFI exhibited reduced splenomegaly and reduced bacterial numbers in the lungs and spleen compared to mice treated with oral ciprofloxacin or doxycycline. When a single dose of CFI was administered, it provided better protection against body weight loss than 7 days of treatment with oral doxycycline, the current antibiotic of choice to treat Q fever. These data suggest that CFI has potential as a superior antibiotic to treat Q fever.

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Section: Norville Et Almentioning

confidence: 99%

Section: Norville Et Almentioning

confidence: 99%

Efficacy of Liposome-Encapsulated Ciprofloxacin in a Murine Model of Q Fever

Norville

Hatch

Bewley

et al. 2014

Antimicrob Agents Chemother

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“…In vitro studies have shown that doxycycline, various fluoroquinolones, macrolides, cotrimoxazole, ri- [8]. Chloroquine is known to raise the pH in the phagolysosome, restoring the bactericidal effect of doxycycline, therefore it is not surprising that the combination of doxycycline and chloroquine has been found to be bactericidal in vitro [9], as well as effective in treating patients with Q fever [10].…”

Section: Discussionmentioning

confidence: 99%

“…In cell culture assays, seven of 13 strains of C. burnetii were intermediately susceptible to erythromycin and six were resistant [11]. In addition, Lever et al found azithromycin to be ineffective in vitro against C. burnetii at concentrations up to 8.0 mg/l [8], whereas Keysari et al reported good in vitro efficacy of azithromycin and clarithromycin, inhibiting C. burnetii growth at concentrations of 0.01 and 0.1 mg/l, respectively; that is, at the concentrations achieved in humans after conventional dosages known to be therapeutic for other infections [12]. The discrepancies in reports on the clinical efficacy of erythromycin have been correlated with heterogeneity of susceptibility among C. burnetii isolates [13].…”

Section: Discussionmentioning

confidence: 99%

Azithromycin for acute Q fever in pregnancy

Cerar

Karner

Avšič-Županc

et al. 2009

Wien Klin Wochenschr

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Q fever is a zoonosis caused by Coxiella burnetii. Although data on Q fever during pregnancy are limited, they indicate that infection with C. burnetii is associated with high morbidity and mortality. The infection is usually asymptomatic in pregnant women but may result in obstetric complications such as spontaneous abortion, intrauterine growth retardation, intrauterine fetal death and premature delivery; in addition, pregnant women are at higher risk of developing chronic Q fever. Treatment of Q fever during pregnancy is challenging not only because C. burnetii is an intracellular bacterium but also because of safety restrictions and limited information on the efficacy of treatment. We report a case of acute Q fever in pregnancy with a successful outcome for mother and child, describe our therapeutic approach to the management of this case, and suggest that treatment with azithromycin may have prevented possible obstetric complications and evolution toward a chronic serologic profile in our patient.

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“…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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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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In vitro susceptibility of Coxiella burnetii to azithromycin, doxycycline, ciprofloxacin and a range of newer fluoroquinolones

Cited by 22 publications

References 6 publications

Efficacy of Liposome-Encapsulated Ciprofloxacin in a Murine Model of Q Fever

Efficacy of Liposome-Encapsulated Ciprofloxacin in a Murine Model of Q Fever

Azithromycin for acute Q fever in pregnancy

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

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