IDSA Recommendations for Treating Bartonella Infections in HIV-AIDS

Preferred Therapy

For Bacillary Angiomatosis, Peliosis Hepatis, Bacteremia, and Osteomyelitis:

 • Doxycycline 100 mg PO or IV q12h (AII), or

 • Erythromycin 500 mg PO or IV q6h (AII)

For Infections Involving the CNS:

 • Doxycycline 100 mg PO or IV q12h +/- rifampin 300 mg PO or IV q12h (AIII)

For Confirmed Bartonella Endocarditis:

 • (Doxycycline 100 mg IV q12h + gentamicin 1 mg/kg IV q8h) x 2 weeks, then continue with doxycycline 100 mg IV or PO q12h (BII), or

 • For patients with renal insufficiency: (doxycycline 100 mg IV q12h + rifampin 300 mg IV or PO q12h) x 2 weeks, then continue with doxycycline 100 mg IV or PO q12h (BII)

Indication for Long-Term Suppressive Therapy - If a relapse occurs after a ≥3 month course of primary treatment:

 • A macrolide or doxycycline as long as the CD4 count remains <200 cells/mm3



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