What is the drug of choice for treatment of Rocky Mountain spotted fever (RMSF)?

Updated: Mar 23, 2021
  • Author: Sunny Patel, DO; Chief Editor: Michael Stuart Bronze, MD  more...
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In adults with Rocky Mountain spotted fever (RMSF), the drug of choice is doxycycline for life-threatening RMSF. Chloramphenicol is an alternative, although doxycycline is preferable because tetracyclines have been shown to be associated with a higher survival rate than chloramphenicol. [20] In vitro and in ovo R rickettsii are also susceptible to rifampin.

Doxycycline therapy also treats Lyme disease, ehrlichiosis, and relapsing fever—entities often clinically confused with RMSF. [21] Oral formulations may be used for patients being treated at home or for hospitalized patients who can take oral medications.

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