Description
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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