Coxiella burnetii Tables

TABLE 1 Summary of Results of Antimicrobial Susceptibility Testing: Coxiella burnetii Using Chick Embryo or Guinea Pig Models
Ref	Author	Model System	Strain(s) Tested	Antibiotic(s) Tested	Results
17	Huebner 1948	Chick embryos Guinea pigs	Strains from patients with acute Q fever	Streptomycin	Reduced mortality
34	Ormsbee 1951	Embryonated eggs	Nine Mile	Aureomycin Terramycin Chloramphenicol Streptomycin Pencillin G	Most effective ↓ Least effective
34	Ormsbee 1951	Chick embryos	Nine Mile	Terramycin Aureomycin Erythromycin Thiocymetin	Effective Effective Ineffective Effective
20	Keren 1994	Chick embryos	Ohio 314 phase I	Minocycline Ciprofloxacin Pefloxacin Fleroxacin	Effective at 8 µg/g egg 1 µg/g egg 6 µg/g egg 1 µg/g egg

TABLE 2 Summary of Results of Antimicrobial Susceptibility Testing: Coxiella burnetii Using Cell Culture Model
Ref	Author	Cell Line	Strain(s) Tested	Antibiotics(s) Tested	Results
20	Keren 1994	Vero cells	Ohio 314	Minocycline Fleroxacin Pefloxacin Ciprofloxacin	95% growth inhibition at 2.5 mg/L 95% growth inhibition at 10 mg/L
59	Torres 1993	HEL cells	Nine Mile Q 212 Priscilla and 10 isolate from patients with chronic Q fever (Marseille)	Ceftriaxone Fusidic acid	Inconclusive results Authors conclude these compounds could be effective
18	Jabarit-Aldighieri 1992	L929 cells with addition of cycloheximide	Q 212 Nine Mile 13 chronic fever Q isolates	PD 127, 391} flouro-PD 131, 628} quinolones	Both quinolones more active against Nine Mile strain than against Q212 (chronic Q fever strain), but neither drug could eliminate infection
40	Raoult 1991	HEL cells	Nine Mile Q212 Priscilla 10 chronic Q fever isolates	Amoxicillin Amikacin Erythromycin Cotrimoxazole Pefloxacin Ciprofloxacin Chloramphenicol Tetracycline Doxycycline Minocycline Rifampin	Nine Mile more susceptible than Q212 or Priscilla; all isolates were resistant to amoxicillin and amikacin; all were susceptible to rifampin, cotrimoxazole, and tetracyclines; heterogeneity of susceptibility to fluoroquinolones, chloramphenicol, and erythromycin
60	Yeaman 1987	L929	Nine Mile	Penicillin G	Pencillin G, polymyxin B,
47	Rolain 2000	HEL cells	Nne Mile Q 212, Priscilla	Telithromycin, erythromycin	MIC for telithromycin 1 mcg/ml vs 8 mcg/ml for erythromycin.
62	Yeaman 1987			Polymyxin B Sulfamethoxazole Trimethoprim Streptomycin Gentamicin Chloramphenicol Rifampin, novobiocin Nalidixic acid Oxolinic acid Ciprofloxacin Norfloxacin Ofloxacin	sulfamethoxazole, trimethoprim, erythromycin, streptomycin, gentamicin-inactive, chloramphenicol, some activity; all others very active
55	Spiridacki	VERO cells	130 isolates	Vibramycin, clarithromycin, ciprofloxacin	Clarithromycin inhibited all isolates at4 mg/L, vibramycin 2 mg/L, ciprofloxacin 8 mg/L.
11	Gikas et al		9 isolates from Greek patients with acute Q fever	Linezolid, pefoloxacin, Ciprofloxacin, trovafloxacin, doxycycline, clarithromycin	MICs for linezolid and clarithromycin ranged from 2 to 4 mg/L.

TABLE 3 Antimicrobial Treatment of Various Manifestations of C. burnetii Infection [Download PDF]
Condition	Treatment¹	Reference
Acute Q fever Pneumonia	1. Doxycycline 100 mg b.i.d. p.o. for 10 days 2. Ciprofloxacin 500 mg b.i.d. p.o. for 10 days	54
Chronic Q fever Endocarditis	1. Doxycycline 100 mg b.i.d. p.o. plus hydroxychloroquine 200 mg t.i.d to achieve a chloroquine level of 1 mg/L 2. Ciprofloxacin 750 mg b.i.d. p.o. plus rifampin 300 mg o.d. p.o. ² 3. Doxycycline 100 mg b.i.d. p.o. plus rifampin 300 mg o.d. p.o.² 4. Doxycycline 100 mg b.i.d. p.o. plus a quinolone b	41 Author’s recommendations, 24 41
Q fever in pregnancy	1. Erythromycin 500 mg q. 6 h p.o. plus rifampin 300 mg o.d. p.o. for the duration of the pregnancy. After delivery, ciprofloxacin 500 mg b.i.d p.o. plus rifampin 300 mg o.d. p.o. for 6 months	Author’s recommendation
Q fever hepatitis	Can occur as an acute or chronic form; treatment is as outlined for acute Q fever; chronic Q fever hepatitis-insufficient data to make any firm recommendations about duration of treatment; would use combination therapy as listed for endocarditis. Prednisone 0.5 mg/kg can be used in those who fail to defervesce.	7

¹1, first choice; 2, choice, etc.

²All regimens to treat chronic Q fever must be given until IgA antiphase I antibody titer is < 1:200,

this usually requires at least 2 years.