Page 217 - Learnwell EVS

7. Bacterial diseases

– Treatment of suspected or confirmed cases

I f treatm ent is b eg un early , reco very is rap id and co m p lete. P enicillins,
cep halo sp o rins and m acro lid es sho uld no t be used .
A m ino gly co sid es, tetracy clines, ch lo ram p h enico l and sulp ho nam id es are
effective.
F o llo w natio nal reco m m end atio ns. F o r info rm atio n:
streptomycin IM fo r 1 0 d ay s

C hild ren: 3 0 m g/ k g/ d ay in 2 d ivid ed d o ses given at 1 2 ho ur-intervals
A d ults: 2 g/ d ay in 2 d ivid ed d o ses given at 1 2 ho ur-intervals
gentamicin IM fo r 1 0 d ay s

Neo nates and child ren und er o ne y ear: 7 .5 m g/ k g/ d ay in 2 d ivid ed d o ses
C hild ren o ver o ne y ear: 6 m g/ k g/ d ay in 2 d ivid ed d o ses
A d ults: 3 m g/ k g/ d ay in 2 d ivid ed d o ses
doxycycline P O fo r 1 0 d ay s

C hild ren o ver 8 y ears and ad ults: 2 0 0 m g/ d ay , o nce d aily o r in 2 d ivid ed d o ses
chloramphenicol P O o r IV fo r 1 0 d ay s

C h ild ren o ver o ne y ear and ad ults: 5 0 m g/ k g/ d ay in 4 d ivid ed d o ses given at
6 ho ur-intervals

Choice of antibiotics

Indications First choice Alternative

B ubo nic p lague d o xy cy cline chlo ram p henico l o r strep to m y cin

P neum o nic p lague strep to m y cin –

S ep ticaem ic p lague strep to m y cin chlo ram p henico l

M eningitic p lague chlo ram p henico l –
gentam icin –
P regnant o r breast-
feed ing 7
wo m en

Note: in o rd er to p revent the em ergence o f resistance to strep to m y cin which is used in
the treatm ent o f tuberculo sis, it is p referable to use d o xy cy cline o r chlo ram p henico l
fo r the treatm ent o f bubo nic p lague.

– CdohxeymcyocplirnoepPhylOaxisthorfocuognhtaocutst the p erio d o f co ntact (m inim um 5 d ay s o f treatm ent)
In the event o f co ntact, and within o ne week after the end o f exp o sure:

cCo-thrilmdorxeanzoolevePr O8 yteharorsuagnhdo audt tuhlets:p1e0rio0 dtoo 2f c0o0nmtactg(/md ainyi,mo nucme d5aildy aoy sr ion f2trdeaivtimd edent)
d o ses

or

C hild ren: 4 0 m g S M X + 8 m g T M P / k g/ d ay in 2 d ivid ed d o ses
A d ults: 1 6 0 0 m g S M X + 3 2 0 m g T M P / d ay in 2 d ivid ed d o ses

Prevention

– F lea vecto r co ntro l is essential to co ntro lling an ep id em ic.
– L o ng-term p reventio n: enviro nm ental sanitatio n and co ntro l o f ro d ent reservo ir.
– V accinatio n against p lague is o nly ind icated fo r p eo p le with a high risk o f exp o sure

(labo rato ry technicians hand ling ro d ents) and can in no circum stances be used as a
m etho d fo r co ntro lling an ep id em ic.