What is the treatment for Anaplasmosis (Anaplasma infection)?

From the Guidelines

Doxycycline is the first-line treatment for Anaplasma infections (anaplasmosis), typically prescribed at 100 mg twice daily for at least 10 days. Treatment should begin immediately upon clinical suspicion, even before laboratory confirmation, as delayed therapy can lead to severe complications 1. For pregnant women, children under 8 years old, or those with doxycycline allergies, alternatives include rifampin (300 mg twice daily for adults) or chloramphenicol, though these are less effective 1. Most patients show improvement within 24-48 hours after starting doxycycline. The medication works by inhibiting bacterial protein synthesis, preventing the bacteria from reproducing.

Some key points to consider in the treatment of anaplasmosis include:

• The dosage of doxycycline for adults is 100 mg twice per day, orally or IV, with a maximum dose of 100 mg per dose 1.
• For children weighing less than 100 lbs (45 kg), the dosage is 2.2 mg/kg of body weight per dose twice per day, orally or IV 1.
• Treatment should be extended to 10 days if concurrent Lyme disease is suspected, or alternatively, another antimicrobial with efficacy against Borrelia burgdorferi should be included 1.
• Patients with anaplasmosis should be treated with doxycycline for 10 days to provide appropriate length of therapy for possible coinfection with B. burgdorferi 1.
• Fever typically subsides within 24–48 hours after treatment when the patient receives doxycycline in the first 4–5 days of illness 1.

Supportive care may be necessary for severe cases, including hospitalization for intravenous antibiotics, fluid management, and monitoring for complications like respiratory failure or coagulopathies. After treatment, follow-up testing is generally unnecessary unless symptoms persist. Prevention measures include using tick repellents, wearing protective clothing in tick-infested areas, and performing regular tick checks after outdoor activities.

From the FDA Drug Label

Doxycycline is indicated for the treatment of the following infections: Rocky Mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers caused by Rickettsiae. The answer to Anaplasma treatment is not directly stated in the provided drug label. Key points:

• The label mentions treatment of infections caused by Rickettsiae, but does not explicitly mention Anaplasma.
• Doxycycline is indicated for various infections, but Anaplasma is not listed. 2

From the Research

Anaplasma Treatment Overview

• Anaplasma phagocytophilum is a bacteria transmitted to humans by tick bites, and its incidence has increased over the past several decades 3.
• The treatment for Anaplasma infection typically involves the use of antibiotics, with doxycycline being the first-line treatment for all ages 4.

Treatment Options

• Doxycycline is effective in treating Anaplasma infections, with a recommended dosage of 100 mg oral twice daily 3.
• Rifampin is also effective in treating Anaplasma infections, particularly in pediatric patients 5.
• Other antibiotics such as ciprofloxacin have shown effectiveness against Anaplasma phagocytophilum in vitro 6.
• Oxytetracycline has been used to treat Anaplasma marginale infections in cattle, but its effectiveness in eliminating persistent infections is limited 7.

Treatment Considerations

• The diagnosis of Anaplasma infection relies on laboratory findings, including inclusion bodies on a peripheral blood smear, leukopenia, thrombocytopenia, and elevated liver enzymes 3.
• The treatment of Anaplasma infection should be started empirically if symptoms and risk factors suggest the disease 4.
• The use of immune serum has shown potential in reducing the number of Anaplasma phagocytophilum bacteria in vitro 6.

Special Considerations for Pediatric Patients

• Pediatric patients with Anaplasma infection typically present with mild symptoms, including fever, headache, and malaise 5.
• Abdominal pain is a prominent complaint in pediatric patients with Anaplasma infection 5.
• Doxycycline and rifampin are effective therapies for pediatric patients with Anaplasma infection 5.