How to Treat Q Fever

Q fever is an infection caused by the Coxiella burnetii rickettsia. This species is widespread and carried by many animals that shed rickettsia in contaminated birth products, feces and urine. Unpasteurized milk also may carry rickettsia, but this is rare. Q fever primarily affects people who work with animals who contract it by inhaling contaminated droplets. The following steps will show how to treat a case of Q fever.

Instructions

Difficulty: Challenging

1. Realize that Q fever usually resolves within two weeks without treatment, but antibiotics may reduce its duration. Continue antibiotic treatment for 14 to 21 days.
2. Use doxycycline as the drug of choice for treating Q fever with fluoroquinolones as good alternatives. Ofloxacin and pefloxacin also have been used successfully.
3. Consider Azithromycin and clarithromycin for pregnant women and children younger than eight years old although some strains of Coxiella burnetii could be resistant. Co-trimazole also could be considered.
4. Expect chronic Q fever to be difficult to treat. A combined antibiotic therapy should be used for a long period based on serology results. Doxycycline with ofloxacin or pefloxacin for at least three years is the most common regimen. Rifampin with a fluoroquinolone is also effective but interferes with anticoagulants.
5. Take quinolones for complications of Q fever by meningoencephalitis because of their high concentration in cerebrospinal fluid. Surgery may be needed for intractable heart failure. Antibiotics should be continued after surgery because Coxiella burnetii can live on endocardial tissue even after valve replacement.