Table 1: Spotted Fever Group Rickettsiosis other Than Rocky Mountain Spotted Fever (Due To R. Rickettsii), and Rickettsialpox (Due To R. Akari) Which Are Presented in Specific Chapters.
|
Syndrome |
Rickettsia sp. |
Arthropod vector |
Geographic |
|
Mediterranean spotted fever |
R. conorii |
Rhipicephalus sanguineus ticks |
Mediterranean areas |
|
Siberian tick typhus |
R. sibirica |
Dermacentor ticks |
Europe, USSR, China |
|
Israeli spotted fever |
unnamed |
R. sanguineus ticks |
Israel, Portugal, Sicily |
|
Queensland tick typhus |
R. australis |
Ixodes holocytus ticks |
Queensland (Australia) |
|
Japanese or Oriental spotted fever |
R. japonica |
Dermacentor and Haemaphysalis ticks |
Japan |
|
Flinders Island spotted fever |
R. honei |
unknown |
Flinder Islands (Australia) |
|
Astrakhan fever |
unnamed |
R. sanguineus ticks R. pumilio ticks |
Astrakhan region (Russia) |
|
African tick bite fever |
R. africae |
Amblyomma variegatum ticks |
Africa, West Indies |
|
Flea typhus of California |
R. felis |
cat fleas (Ctenocephalides felis) |
United States, Mexico |
|
spotted fever |
Rickettsia mongolotimonae |
Hyalomma ticks |
Europe, People’s Republic of China |
|
Wood scar |
R. slovaca |
Dermacentor marginatus |
Europe |
Table 2: In Vitro Antibiotic Susceptibility of R. Conorii. MICs (µG/Ml) are Presented for R. Conorii Moroccan (ATCC VR-141) and Seven (ATCC VR-613) Strains As Determined By Using the Plaque Assay and The Dye Uptake Assay, and For R. Conorii Seven As Determined By Using An Indirect Fluorescent Antibody (IFA) Test.
| Antibiotics | MICs in cell cultures (µg/ml) | References | |||
| Plaque assay | Dye uptake | IFA test | Strain | ||
| amoxicillin | 128 | 128 | Moroccan | (41) | |
| 128 | 128 | 7 | (41) | ||
| gentamicin | 8 | 8 | Moroccan | (41) | |
| 8 | 8 | 7 | (41) | ||
| chloramphenicol | 0.5 | 0.25 | Moroccan | (31) | |
| thiamphenicol | 1 | 2 | Moroccan | (41) | |
| 1 | 2 | 7 | (41) | ||
| tetracycline | 0.25 | 0.25 | Moroccan | (31) | |
| doxycycline | 0.06 | 0.12 | Moroccan | (31) | |
| 0.06 | 0.125 | 7 | (41) | ||
| erythromycin | 4 | 4 | Moroccan | (31) | |
| 8 | 8 | 7 | (41) | ||
| 8 | 7 | (32) | |||
| spiramycin | 16 | 32 | Moroccan | (33) | |
| josamycin | 1 | 1 | Moroccan | (33) | |
| 0.5 | 0.5 | 7 | (41) | ||
| pristinamycin | 2 | 2 | Moroccan | (41) | |
| 2 | 1 | 7 | (41) | ||
| clarithromycin | 2 | 2 | Moroccan | (34) | |
| 1 | 1 | 7 | (41) | ||
| 4 | 7 | (32) | |||
| azithromycin | 16 | 7 | (32) | ||
| dirithromycin | 16 | 7 | (32) | ||
| roxithromycin | 16 | 7 | (32) | ||
| telithromycin | 0.5 | Moroccan | (35) | ||
| rifampin | 0.25 | 0.25 | Moroccan | (31) | |
| 0.125 | 0.125 | 7 | (41) | ||
| ciprofloxacin | 0.25 | 0.25 | Moroccan | (31) | |
| 0.5 | 0.5 | 7 | (41) | ||
| 16.3 | 7 | (38) | |||
| ofloxacin | 1 | Moroccan | (36) | ||
| 1 | 1 | 7 | (41) | ||
| 5.2 | 7 | (38) | |||
| pefloxacin | 1 | 0.5 | Moroccan | (23) | |
| 0.5 | 1 | 7 | (41) | ||
| sparfloxacin | 0.25 | 0.5 | Moroccan | (40) | |
| 1.1 | 7 | (38) | |||
| levofloxacin | 1.6 | 7 | (38) | ||
| sulfamethoxazole | >8 | >8 | Moroccan | (41) | |
| >8 | >8 | 7 | (41) |
Table 3: In Vitro Antibiotic Susceptibility of Spotted Fever Group Rickettsiae Other than R. Rickettsii, R; Conorii, and R. Akari. Minimum Inhibitory Concentrations (µG/Ml) As Determined In the Plaque Assay Are Summarized (41).
| Strain | Doxy | Thiam | Rifam | Ery | Clar | Josa | Prist | Cip | Ofl | Pef |
| R. conorii serotype Israeli | 0.06 | 1 | 0.5 | 4 | 1 | 0.5 | 1 | 0.5 | 1 | 1 |
| R. conorii serotype Astrakhan (A-167) | 0.06 | 0.5 | 0.03 | 8 | 0.5 | 0.5 | 2 | 0.5 | 0.5 | 0.5 |
| R. sibirica (246) | 0.06 | 0.5 | 0.06 | 2 | 2 | 1 | 2 | 1 | 1 | 1 |
| R. australis (Phillips) | 0.06 | 2 | 0.125 | 8 | 4 | 0.5 | 2 | 0.5 | 1 | 1 |
| R. japonica (YM) | 0.125 | 1 | 0.25 | 8 | 1 | 1 | 8 | 1 | 1 | 1 |
| R. honei (RB) | 0.06 | 2 | 0.5 | 4 | 1 | 0.5 | 2 | 1 | 1 | 1 |
| R. africae (ESF-5) | 0.125 | 1 | 0.125 | 8 | 2 | 0.5 | 2 | 0.5 | 1 | 1 |
| R. "mongolotimonae" | 0.125 | 1 | 0.125 | 8 | 4 | 1 | 2 | 1 | 1 | 1 |
| R. slovaca (13-B) | 0.06 | 1 | 0.5 | 2 | 0.5 | 1 | 1 | 1 | 1 | 1 |
doxy : doxycycline;
thiam : thiamphenicol; rifam : rifampin; ery : erythromycin; clar :
clarithromycin; josa : josamycin; prist : pristinamycin; cip :
ciprofloxacin; ofl : ofloxacin; pef : pefloxacin.
Table 4 : In Vitro Antibiotic Susceptibility of Rickettsiae Isolated Only From Ticks. Minimum Inhibitory Concentrations (µG/Ml) as Determined in the Plaque Assay Are Summarized (41).
| Strain | Doxy | Thiam | Rifam | Ery | Clar | Josa | Prist | Cip | Ofl | Pef |
|
R. bellii (369L42-1) |
0.125 |
0.5 |
0.06 |
4 |
4 |
1 |
2 |
0.5 |
0.5 |
1 |
|
R. canada (2678) |
0.06 |
1 |
0.125 |
4 |
1 |
1 |
2 |
0.5 |
0.5 |
1 |
|
R. helvetica (C9P9) |
0.125 |
1 |
0.06 |
2 |
1 |
0.5 |
2 |
0.25 |
0.5 |
1 |
|
R. parkeri (Maculatum) |
0.25 |
4 |
0.25 |
4 |
1 |
0.5 |
2 |
0.25 |
0.25 |
0.5 |
|
Thai tick typhus rickettsia |
0.06 |
2 |
0.125 |
8 |
1 |
1 |
4 |
0.5 |
2 |
1 |
|
strain Bar 29 |
0.06 |
1 |
2 |
4 |
2 |
0.5 |
4 |
0.25 |
0.5 |
0.5 |
|
R. massiliae |
0.06 |
1 |
2 |
2 |
1 |
1 |
1 |
0.25 |
0.5 |
0.5 |
|
R. aeschlimanii |
0.06 |
1 |
2 |
8 |
1 |
0.5 |
2 |
0.5 |
0.5 |
1 |
|
R. montana (ATCC VR-611) |
0.125 |
2 |
2 |
8 |
1 |
2 |
4 |
1 |
1 |
1 |
|
R. rhipicephali |
0.25 |
1 |
2 |
4 |
1 |
1 |
2 |
1 |
1 |
1 |
doxy : doxycycline; thiam : thiamphenicol; rifam : rifampin; ery : erythromycin; clar : clarithromycin; josa : josamycin; prist : pristinamycin; cip : ciprofloxacin; ofl : ofloxacin; pef : pefloxacin
Table 5: Summary of Randomized Clinical Trials of Antibiotic Therapy for Mediterranean Spotted Fever
| Drugs and regimens | n° of patients | Results | references |
| doxycycline, 1 day (200mg two times) vs. Tetracycline, 10 days (500mg qid) | 70 | NS | (47) |
| clarithromycin, 7 days (7.5 mg bid) vs. chloramphenicol, 7 days (12.5mg/kg qid) | 46 | more rapid defervescence with clarithromycin | (53) |
| erythromycin, 10 days (12.5mg/kg qid) vs. tetracycline, 10 days (10 mg/kg qid) | 81 | more rapid disappearance of fever and symptoms with tetracycline | (52) |
| azithromycin, 3days (10 mg/kg once daily) vs.doxycycline, 5 days (5mg/kg once daily) | 30 | NS | (54) |
| josamycin, 5 days (25 mg/kg bid) vs. doxycycline, 1 day (2.5 mg/kg bid) | 59 | NS | (46) |
| azithromycin, 3 days (10 mg/kg once daily) vs. clarithromycin, 7 days (7.5 mg/kg bid) | 87 | NS | (55) |
| ciprofloxacin, 2 days (500mg bid) vs. doxycycline, 2 days (100mg bid) | 43 | more rapid disappearance of fever and symptoms with doxycycline | (59) |
| ciprofloxacin, 7 days (750mg bid) vs. doxycycline, 7 days (100mg bid) | 70 | NS | (60) |
| rifampin, 5 days (10mg/kg bid) vs. doxycycline, 1 day (200mg two times) | 32 | more rapid disappearance of fever with doxycycline | (58) |