New Guidance on Tularemia Treatment and Postexposure Prophylaxis

Clinical Takeaway

: Updated CDC guidelines recommend fluoroquinolones or doxycycline as first-line therapy, both for treatment of diagnosed disease and for prophylaxis after exposure.

Sponsoring Organization: U.S. Centers for Disease Control and Prevention (CDC)

Background

For the first time since 2001, the CDC has updated its recommendations for tularemia treatment and postexposure prophylaxis (PEP). Tularemia, which is caused by Francisella tularensis, is endemic in the northern hemisphere and results in both sporadic cases and outbreaks, especially during war. Because relatively few organisms (<100) are required to initiate infection, F. tularensis could be weaponized for bioterrorism.

Key Recommendations

First-line options for the treatment of tularemia in both children and adults are fluoroquinolones (ciprofloxacin or levofloxacin), gentamicin, and doxycycline. Treatment duration is 10 days for all agents except doxycyc…

Reviewing Author

Anna Wald, MD, MPH

Disclosures

Consultant/Advisory BoardAicuris; Bayer; GSK; Innovative Molecules; Merck; MAPP Biopharmaceutical (Safety Monitoring Committee)

RoyaltiesUpToDate

Grant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; GSK; Moderna; Assembly Biomedical; Aicuris

Editorial BoardsSexually Transmitted Diseases; Sexually Transmitted Infections; Journal of Infectious Diseases

Leadership PositionsID Division Chiefs Community of Practice (At-Large Member)