Tick Borne Relapsing Fever Treatment
Erythromycin, tetracyclines, chloramphenicol, or penicillins have all been shown to be effective for treating TBRF. Although duration of therapy has not been well studied for TBRF, the current recommendation is seven days of antibiotic therapy. In contrast, LBRF caused by B. recurrentis can be treated with a single dose of antibiotics.
For young children and pregnant women either erythromycin and/or penicillin are recommended for treatment of TBRF.
When initiating antibiotic therapy, a patient should be watched closely for a Jarisch-Herxheimer reaction for the first 4 hours after the antibiotic is given (Negussie, Remick et al. 1992). The reaction may be difficult to distinguish from a febrile crisis, with rigors and decreased blood pressure. Cooling blankets and appropriate use of antipyrectic agents may be indicated.
The CDC has not developed specific treatment guidelines for TBRF. Below are the treatment recommendations as outlined in Harrisons Principles of Internal Medicine. 16th edition. 2004. p 994.
Treatment tables
Dosing of oral medication for a seven day course
- Medication
- • Erythromycin
- • Tetracycline
- • Doxycycline
- • Chloramphenicol
- Dose
- • 500mg
- • 500mg
- • 100mg
- • 500mg
- Dosing interval
- • Every 6 hours
- • Every 6 hours
- • Every 12 hours
- • Every 6 hours
Dosing for parental medication for a seven day course
- Medication
- • Erythromycin
- • Tetracycline
- • Doxycycline
- • Chloramphenicol
- • Penicillin G
- Dose
- • 500mg
- • 250mg
- • 100mg
- • 500mg
- • 600,000IU
- Dosing interval
- • Every 6 hours
- • Every 6 hours
- • Every 12 hours
- • Every 6 hours
- • Once a day
Content Source:
Division of Vector Borne Infectious Diseases
National Center for Zoonotic, Vector-Borne, and Enteric Diseases