Successful Treatment of Human Plague with Oral Ciprofloxacin

Apangu, Titus; Griffith, Kevin S.; Abaru, Janet; Candini, Gordian; Apio, Harriet; Okoth, Felix; Okello, Robert; Kaggwa, John; Acayo, Sarah; Ezama, Geoffrey; Yockey, Brook; Sexton, Christopher; Schriefer, Martin E.; Mbidde, Edward; Mead, Paul S.

doi:10.3201/eid2303.161212

Cited by 31 publications

(19 citation statements)

References 7 publications

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“…We included patients who visited facilities where active surveillance was not being performed in this study; however, we excluded patients who sought healthcare in the region but were residents of another country (i.e., nearby Democratic Republic of the Congo) because of the inability to perform follow-up. The standard treatment for suspected plague in Uganda is doxycycline or chloramphenicol; during the period covered by this surveillance summary, a concurrent treatment trial evaluating the efficacy of oral ciprofloxacin against the national standard was also being conducted ( 14 ).…”

Section: Methodsmentioning

confidence: 99%

Patterns of Human Plague in Uganda, 2008–2016

Forrester¹,

Apangu²,

Griffith³

et al. 2017

Emerg. Infect. Dis.

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Plague is a highly virulent fleaborne zoonosis that occurs throughout many parts of the world; most suspected human cases are reported from resource-poor settings in sub-Saharan Africa. During 2008–2016, a combination of active surveillance and laboratory testing in the plague-endemic West Nile region of Uganda yielded 255 suspected human plague cases; approximately one third were laboratory confirmed by bacterial culture or serology. Although the mortality rate was 7% among suspected cases, it was 26% among persons with laboratory-confirmed plague. Reports of an unusual number of dead rats in a patient’s village around the time of illness onset was significantly associated with laboratory confirmation of plague. This descriptive summary of human plague in Uganda highlights the episodic nature of the disease, as well as the potential that, even in endemic areas, illnesses of other etiologies might be being mistaken for plague.

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Section: Methodsmentioning

confidence: 99%

Patterns of Human Plague in Uganda, 2008–2016

Forrester¹,

Apangu²,

Griffith³

et al. 2017

Emerg. Infect. Dis.

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“…Although the scarcity of relevant clinical data makes it difficult to determine the superiority of one treatment over another [ 22 , 121 , 123 , 124 ], the antibiotics’ pharmacodynamic and pharmacokinetic properties can be taken into account when selecting treatments. For example, fluoroquinolones might (like tetracyclines) be more efficacious than aminoglycosides because they accumulate in the cell and diffuse more readily into necrotic tissues, such as the bubo [ 125 , 126 , 127 ].…”

Section: Antimicrobial Chemotherapymentioning

confidence: 99%

Antibiotic Therapy of Plague: A Review

Sebbane

Lemaître

2021

Biomolecules

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Plague—a deadly disease caused by the bacterium Yersinia pestis—is still an international public health concern. There are three main clinical forms: bubonic plague, septicemic plague, and pulmonary plague. In all three forms, the symptoms appear suddenly and progress very rapidly. Early antibiotic therapy is essential for countering the disease. Several classes of antibiotics (e.g., tetracyclines, fluoroquinolones, aminoglycosides, sulfonamides, chloramphenicol, rifamycin, and β-lactams) are active in vitro against the majority of Y. pestis strains and have demonstrated efficacy in various animal models. However, some discrepancies have been reported. Hence, health authorities have approved and recommended several drugs for prophylactic or curative use. Only monotherapy is currently recommended; combination therapy has not shown any benefits in preclinical studies or case reports. Concerns about the emergence of multidrug-resistant strains of Y. pestis have led to the development of new classes of antibiotics and other therapeutics (e.g., LpxC inhibitors, cationic peptides, antivirulence drugs, predatory bacteria, phages, immunotherapy, host-directed therapy, and nutritional immunity). It is difficult to know which of the currently available treatments or therapeutics in development will be most effective for a given form of plague. This is due to the lack of standardization in preclinical studies, conflicting data from case reports, and the small number of clinical trials performed to date.

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“…They also give the possibility to switch to other treatments after the acute phase (switch to ciprofloxacin after the early phase of streptomycin treated cases). Gentamycin, fluoroquinolones, chloramphenicol, doxycycline, and trimethoprim-sulfamethoxazole are different alternatives used in different settings, which generally result in good clinical outcomes [ 1 , 7 , 77 ]. A well-established first-line treatment for suspected pneumonic plague needs to be established that is affordable, is orally administered, has few side effects, is continuously available, and has a wide spectrum of activity to target other community-acquired respiratory diseases.…”

Section: How Can Plague Surveillance and Case Management Be Improved?mentioning

confidence: 99%

Human plague: An old scourge that needs new answers

et al. 2020

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Yersinia pestis, the bacterial causative agent of plague, remains an important threat to human health. Plague is a rodent-borne disease that has historically shown an outstanding ability to colonize and persist across different species, habitats, and environments while provoking sporadic cases, outbreaks, and deadly global epidemics among humans. Between September and November 2017, an outbreak of urban pneumonic plague was declared in Madagascar, which refocused the attention of the scientific community on this ancient human scourge. Given recent trends and plague's resilience to control in the wild, its high fatality rate in humans without early treatment, and its capacity to disrupt social and PLOS NEGLECTED TROPICAL DISEASES

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Successful Treatment of Human Plague with Oral Ciprofloxacin

Cited by 31 publications

References 7 publications

Patterns of Human Plague in Uganda, 2008–2016

Patterns of Human Plague in Uganda, 2008–2016

Antibiotic Therapy of Plague: A Review

Human plague: An old scourge that needs new answers

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