Which antibiotics are effective for the treatment of severe cat scratch disease (CSD)?

Updated: Feb 16, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Margileth et al reported the results of therapy for catscratch antigen–proven CSD with 18 different antimicrobials in 268 adult and pediatric patients. [63] They concluded that the following 4 antibiotics were the most effective for patients with severe CSD:

  • Rifampin - Efficacy of 87%

  • Ciprofloxacin - Efficacy of 84%

  • Gentamicin intramuscularly - Efficacy of 73%

  • Trimethoprim/sulfamethoxazole (TMP-SMZ) - Efficacy of 58%

These agents were considered moderately to highly effective, producing reduction or resolution of lymphadenopathy, a declining erythrocyte sedimentation rate, and decreased inflammatory and constitutional symptoms within 3-10 days. Severe disease was defined as persistent high fever (>103.1°F [>39.5˚C]) with severe systemic signs (eg, malaise, fatigue, blindness, headache) and lymphadenitis.

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