Francisella tularensis

Background:

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Other   (Gram Negative Bacilli)  
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>Aeromonas species:
     1] Aeromonas hydrophila
     2] Aeromonas veronii
     3] Aeromonas shubertii
>Bartonella species:
     1] Bartonella bacilliformis
     2] Bartonella henselae (organism responsible for cat scratch disease)
     3] Bartonella Quintana
     4] Other
>Campylobacter:
     1] Campylobacter fetus
     2] Campylobacter jejuni
>Capnocytophaga species:
     1] Capnocytophaga canimorsus
     2] Capnocytophaga ochracea
>Francisella tularensis led
>Helicobacter pylori
>Legionella species: ( L. pneumophila)
>Plesiomonas shigelloides
>Vibrio species:
     1] Vibrio cholera
     2] Vibrio parahaemolyticus
     3] Vibrio damsela
     4] Other

Francisella tularensis

  • Pathogenic species of Gram-negative bacteria and the causative agent of tularemia.
  • Fastidious, facultative intracellular bacterium which requires cysteine for growth.
  • Due to its low infectious dose, ease of spread by aerosol and high virulence, F. tularensis is classified as a Class A Select Agent by the U.S. government, along with other potential agents of bioterrorism such as Yersinia pestis, Smallpox and Ebola.

 

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Therapy:

Important considerations:  The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions.   Generally, the most common agents/regimens are listed first.  Listed dosages may need to be adjusted for renal dysfunction.  

  1. Streptomycin 0.5 – 1 gram IM q12h x 10 days (Maximum: 2 grams/day)
  2. Gentamicin 5 mg/kg/day IV x 10 days – Adjust regimen based on estimated clearance.
  3. Doxycycline 100mg IV/oral twice daily
  4. Ciprofloxacin 750 mg orally q12h or 400mg IV q12h
  5. Severe disease e.g. meningitis: 
    • [Gentamicin 5 mg/kg/day IV x 10 days – Adjust regimen based on estimated clearance  OR Streptomycin 0.5 – 1 gram IM q12h x 10 days ]
    • PLUS 
    • [Chloramphenicol 50-100 mg/kg/day IV in divided doses every 6 hours (Maximum daily dose is 4 grams e.g. 1 gram q6h)   OR   Doxycycline 100mg IV  twice daily] 

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user’s use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. Read the disclaimer