Gram Indeterminate - Treatments

Question 1

Treatment for Chlamydia trachomatis?

Answer 1

Azithromycin (1 dose 97% effective) - standard
…or doxycycline (b.i.d. 7 days 100% effective)

Include ceftriaxone for gonorrhea co-infection

Expedited partner therapy

Question 2

Treatment for trichiasis?

Answer 2

Surgery or epilation (removal of eyelashes), doxy/macrolide ointment

Question 3

Treatment for Chlamydophila pneumoniae?

Mild URT to maybe walking pneumonia; associated with coronary artery disease

Answer 3

Usually untreated; tetracyline

Question 4

Treatment for Chlamydophila psittaci?

Acute/severe pneumonia; patchy lung involvement

Answer 4

Must treat - tetracycline (quarantine imported birds)

Question 5

What should you NOT use to treat Coxiella burnetti?

Answer 5

Sulfonamides - enhances the growth!

folic acid synthesis not required; bacteria uses host’s adenine

Question 6

Treatment for:

• Rickettsia prowazekii, typhi, akari
• Rickettsia rickettsii
• Ehrlichia chaffeensis
• Anaplasma phagocytophilum
• Coxiella burnetti

Answer 6

Doxycyline, tetracycline

Question 7

Treatment for Mycoplasma pneumoniae?

Answer 7

Often none if mild

Tetracycline, erythromycin

NO penicillins - no cell wall