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Evidence summaries

Fluoroquinolones in the Treatment of Tularaemia

Fluoroquinolones may be recommended for the treatment of tularaemia. Level of evidence: "C"

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 In 2 cases, treatment was withdrawn after 3 and 7 days because of rash.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]

Primary/Secondary Keywords