Prophylaxis after Exposure to Coxiella burnetii

September 29, 2008 at 5:44 pm Leave a comment

Emerging Infectious Diseases  October 2008  V.14  N.10

Claire E. Moodie,  Herbert A. Thompson, Martin I. Meltzer, and David L. Swerdlow

Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Coxiella burnetii is a category B bioterrorism agent. We numerically evaluated the risks and benefits from postexposure prophylaxis (PEP) after an intentional release of C. burnetii to the general population, pregnant women, and other high-risk populations. For each group, we constructed a decision tree to estimate illness and deaths averted by use of PEP/100,000 population. We calculated the threshold points at which the number of PEP-related adverse events was equal to the cases averted. PEP was defined as doxycycline (100 mg 2×/day for 5 days), except for pregnant women, where we assumed a PEP of trimethoprim-sulfamethoxazole (160 mg/800 mg 2×/day) for the duration of the pregnancy. PEP would begin 8–12 days postexposure. On the basis of upper-bound probability estimates of PEP-related adverse events for doxycycline, we concluded that the risk for Q fever illness outweighs the risk for antimicrobial drug–related adverse events when the probability of C. burnetii exposure is >7% (pregnant women using trimethoprim-sulfamethoxazole = 16%).

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Entry filed under: Antimicrobianos, Bacterias, Infecciones respiratorias, Medicina del viajero, Profilaxis Post-Exposición, Uncategorized.

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