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Rocky Mountain Spotted Fever Home > Treatment
Treatment
Appropriate antibiotic treatment should be initiated immediately
when there is a suspicion of Rocky Mountain spotted fever on the basis of clinical and
epidemiologic findings. Treatment should not be delayed until laboratory
confirmation is obtained.
If the patient is treated within the first 4-5 days
of the disease, fever generally subsides within 24-72
hours after treatment with an appropriate antibiotic
(usually in the tetracycline class). In fact, failure
to respond to a tetracycline antibiotic argues against
a diagnosis of RMSF. Severely ill patients may require
longer periods before their fever resolves, especially
if they have experienced damage to multiple organ systems.
Preventive therapy in non-ill patients who have had
recent tick bites is not recommended and may,
in fact, only delay the onset of disease.
Doxycycline (100 mg every 12 hours for adults or 4 mg/kg body weight per day in two divided doses for children under
45 kg
[100 lbs]) is the drug of choice for patients with Rocky Mountain spotted
fever. Therapy is
continued for at least 3 days after fever subsides and until there is
unequivocal evidence of clinical improvement, generally for a minimum total
course of 5 to 10 days. Severe or complicated disease may require longer
treatment courses. Doxycycline is also the preferred drug for patients
with ehrlichiosis, another tick-transmitted infection with signs and
symptoms that may resemble Rocky Mountain spotted fever.
Tetracyclines are
usually not the preferred drug for use in
pregnant women because of risks associated with malformation of teeth and
bones in unborn children. Chloramphenicol is an alternative drug that can be used
to treat Rocky Mountain spotted fever; however, this drug may be associated with a wide range of
side effects and may require careful monitoring of blood levels.
Date last reviewed: 05/20/2005 |
