Is All-Oral Treatment an Option for Whipple's Disease?

For patients with Whipple's disease — a rare condition caused by chronic infection with Tropheryma whipplei — typical treatment is parenteral ceftriaxone or meropenem for 2 weeks followed by oral trimethoprim–sulfamethoxazole (TMP/SMX) for 1 year. Because the intravenous access may require hospitalization, and long-term TMP/SMX may be challenging in real-world settings, researchers performed an open-label, randomized, controlled trial of all-oral therapy in adults with confirmed Whipple's disease. Sixty patients were included. The most common systems involved were gastrointestinal, osteoarticular, and neurologic. People with isolated Whipple's endocarditis were excluded, but some participants had endocardial or pericardial involvement. The …