From the Guidelines
The recommended treatment for Pasteurella multocida infections is amoxicillin-clavulanate (Augmentin), typically dosed at 875/125 mg twice daily for adults for 7-14 days depending on infection severity, as per the most recent guidelines from the Infectious Diseases Society of America 1.
Key Considerations
- For penicillin-allergic patients, alternatives include doxycycline (100 mg twice daily), trimethoprim-sulfamethoxazole (one double-strength tablet twice daily), or fluoroquinolones like ciprofloxacin (500 mg twice daily) 1.
- Severe infections may require intravenous antibiotics such as ampicillin-sulbactam, piperacillin-tazobactam, or carbapenems 1.
- Treatment should begin promptly, especially for animal bite wounds, as P. multocida can cause rapidly progressing infections.
- The bacterium is highly susceptible to penicillins because it lacks beta-lactamase production in most strains, making amoxicillin-clavulanate particularly effective 1.
- However, P. multocida is naturally resistant to certain antibiotics including dicloxacillin, nafcillin, and vancomycin, which should be avoided.
Additional Recommendations
- Wound care including thorough cleaning, debridement if necessary, and elevation of the affected area is also essential alongside antibiotic therapy.
- Cultures are often not done on wounds, and empirical therapy might miss pathogens, so broader empirical coverage for abscesses might yield better therapeutic results 1.
- A more focused therapy for nonpurulent infected wounds could allow narrower therapy.
Important Notes
- The guidelines from the Infectious Diseases Society of America provide the most up-to-date recommendations for the treatment of Pasteurella multocida infections 1.
- The choice of antibiotic should be based on the severity of the infection, the patient's allergy history, and the potential for resistance 1.
From the FDA Drug Label
Doxycycline is indicated for the treatment of infections caused by the following gram-negative microorganisms: Chancroid caused by Haemophilus ducreyi. Plague due to Yersinia pestis (formerly Pasteurella pestis). Tularemia due to Francisella tularensis (formerly Pasteurella tularensis).
The recommended treatment for Pasteurella multocida infections is not directly stated in the drug label. However, Tularemia is caused by Francisella tularensis (formerly Pasteurella tularensis), and Plague is caused by Yersinia pestis (formerly Pasteurella pestis), which are both treated with doxycycline. But Pasteurella multocida is not explicitly mentioned as an indication for doxycycline treatment. Therefore, no conclusion can be drawn about the effectiveness of doxycycline for Pasteurella multocida infections based on this label 2.
From the Research
Treatment Options for Pasteurella multocida Infections
- The recommended treatment for Pasteurella multocida infections is penicillin or its derivatives, such as amoxicillin 3, 4.
- In cases where the patient is allergic to penicillin, alternative oral agents such as ampicillin, amoxicillin/clavulanate, cefprozil, cefuroxime, and trimethoprim/sulfamethoxazole may be used 3.
- For severe infections, intravenous antibiotics such as ceftazidime and gentamicin may be effective 5.
- In some cases, treatment with dressings containing honey and antibacterials may be a viable option, especially for patients who refuse surgical intervention 6.
Antimicrobial Susceptibility
- Pasteurella multocida isolates are generally susceptible to most widely used antimicrobial agents, but resistance to sulphonamides, tetracyclines, first-generation quinolones, and aminoglycosides has been reported 7.
- The use of classical penicillin, newer macrolides, third-generation fluoroquinolones, and fourth-generation cephalosporins has been shown to be effective against P. multocida 7.