Fluoroquinolones in the Treatment of Tularaemia

The in vitro susceptibility to antibiotics was determined in 38 strains of Francisella tularensis palaearctica 1. The MIC(90) values for quinolones were low, 0.016 mg/l for both ciprofloxacin and levofloxacin. Susceptibility to the antibiotics traditionally used to treat tularaemia was poorer: tetracycline (MIC(90) 0.38 mg/l, streptomycin (MIC(90) 4.0 mg/l, tobramycin (MIC(90) 1.5 mg/l, and gentamicin (MIC(90) 1.0 mg/l.

In a case series study 2, 12 paediatric patients (median age 4 years; range 1 to 10) with ulceroglandular tularaemia were treated with a 10- to 14-day course of oral ciprofloxacin, 15 to 20 mg/kg daily in 2 divided doses. Defervescence occurred within 4 days of the institution of the antibiotic in all patients. In 2 cases, treatment was withdrawn after 3 and 7 days because of rash. In both cases a second episode of fever occurred. All children recovered without complications.

References

• Ikäheimo I, Syrjälä H, Karhukorpi J, Schildt R, Koskela M. In vitro antibiotic susceptibility of Francisella tularensis isolated from humans and animals. J Antimicrob Chemother 2000 Aug;46(2):287-90. [PubMed]
• Johansson A, Berglund L, Gothefors L, Sjöstedt A, Tärnvik A. Ciprofloxacin for treatment of tularemia in children. Pediatr Infect Dis J 2000 May;19(5):449-53. [PubMed]