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Appropriate antibiotic treatment should be initiated
immediately when there is a suspicion of Rocky Mountain spotted
fever on the basis of clinical and epidemiologic findings. Treatment
should not be delayed until laboratory confirmation is
obtained.
If the patient is treated within the first 4-5 days of the
disease, fever generally subsides within 24-72 hours after treatment
with an appropriate antibiotic (usually a tetracycline). In fact,
failure to respond to a tetracycline antibiotic argues against a
diagnosis of RMSF. Severely ill patients may require longer periods
before their fever resolves, especially if they have experienced
damage to multiple organ systems. Preventive therapy in non-ill
patients who have had recent tick bites is not recommended
and may, in fact, only delay the onset of disease.
Doxycycline (100 mg every 12 hours for adults or 4 mg/kg body
weight per day in two divided doses for children under 45 kg [100
lbs]) is the drug of choice for patients with Rocky Mountain spotted
fever. Therapy is continued for at least 3 days after fever subsides
and until there is unequivocal evidence of clinical improvement,
generally for a minimum total course of 5 to 10 days. Severe or
complicated disease may require longer treatment courses.
Doxycycline is also the preferred drug for patients with
ehrlichiosis, another tick-transmitted infection with signs and
symptoms that may resemble Rocky Mountain spotted fever.
Tetracyclines are usually not the preferred drug for use in
pregnant women because of risks associated with malformation of
teeth and bones in unborn children. Chloramphenicol is an
alternative drug that can be used to treat Rocky Mountain spotted
fever; however, this drug may be associated with a wide range of
side effects and may require careful monitoring of blood levels.
Other Pages with information on Rocky Mountain Spotted Fever:
Rocky
Mountain Spotted Fever - History
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Rocky Mountain Spotted Fever Overview
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Rocky
Mountain Spotted Fever The Organism
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Rocky Mountain Spotted Fever
Epidemiology
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Rocky Mountain Spotted Fever
Signs and Symptoms
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Rocky Mountain spotted fever
Detection
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Rocky Mountain Spotted Fever
Treatment
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Rocky Mountain Spotted Fever
Prevention and Control
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