From the Guidelines
Cat scratch disease is typically treated with azithromycin, which has been shown to reduce lymph node size by 80% at 30 days in a single, double-blind placebo-controlled study 1. The recommended dose of azithromycin is 500 mg on day 1, followed by 250 mg once daily for 4 additional days for patients weighing ≥45.5 kg, and 10 mg/kg orally on day 1, then 5 mg/kg on days 2–5 for those weighing <45.5 kg 1. Some key points to consider in the treatment of cat scratch disease include:
- Azithromycin is the recommended first-line treatment, with a strong, moderate recommendation 1
- The treatment course is typically 5 days, with a specific dosing protocol based on patient weight 1
- In addition to antibiotics, treatment may include over-the-counter pain relievers, warm compresses, and rest and adequate hydration to manage symptoms
- Early treatment is important to prevent complications and reduce the duration of symptoms, as most cases resolve within 2-4 weeks with treatment 1
- Severe cases may require hospitalization and intravenous antibiotics, highlighting the importance of prompt and effective treatment.
From the Research
Treatment Overview
- The majority of Cat Scratch Disease (CSD) cases resolve spontaneously and do not require antibiotic treatment 2, 3, 4.
- In complicated CSD, treatment with antibiotics such as trimethoprim-sulphamethoxazole, ciprofloxacin, or azithromycin is recommended 2, 3.
- Gentamicin is reserved for severely ill patients 2.
Antibiotic Treatment
- Azithromycin has been shown to be effective in treating CSD, with one study demonstrating a more rapid diminution in size of infected lymph nodes 3, 5.
- Other antibiotics that have been used to treat CSD include rifampin, ciprofloxacin, clarithromycin, and trimethoprim-sulfamethoxazole 3.
- A prospective, randomized, double-blind, placebo-controlled clinical trial found that azithromycin treatment for 5 days resulted in a significant decrease in lymph node volume within the first month of treatment 5.