From the Guidelines
The recommended antibiotic regimen for treating Aeromonas infections is doxycycline plus ciprofloxacin or ceftriaxone, as outlined in the 2014 update by the Infectious Diseases Society of America 1.
Key Considerations
- The choice of antibiotic should be based on the severity of the infection and the patient's clinical presentation.
- For adult patients, the recommended dosage is doxycycline 100 mg every 12 hours IV, ciprofloxacin 500 mg every 12 hours IV, or ceftriaxone 1 to 2 g every 24 hours IV 1.
- In cases of severe or systemic infections, intravenous therapy may be necessary, and the treatment duration typically ranges from 7-14 days for uncomplicated infections to 2-3 weeks for more severe cases.
Important Notes
- Aeromonas species often produce beta-lactamases, making them resistant to ampicillin and first-generation cephalosporins, which explains why broader-spectrum antibiotics are preferred.
- Antibiotic susceptibility testing is important as resistance patterns can vary, and therapy may need adjustment based on clinical response.
- Surgical debridement may be necessary as an adjunct to antibiotic therapy in cases of necrotizing fasciitis or deep tissue infections caused by Aeromonas.
Pediatric Considerations
- The recommended antibiotic regimen for pediatric patients is not well established, but doxycycline plus ciprofloxacin or ceftriaxone may be used in life-threatening situations, with careful consideration of the potential risks and benefits 1.
From the Research
Antibiotic Regimens for Treating Aeromonas Infections
The following antibiotic regimens are recommended for treating Aeromonas infections:
- Aztreonam, piperacillin, and mezlocillin are highly active against all strains of Aeromonas tested 2
- Third-generation cephalosporins, such as cefotaxime, are effective against most Aeromonas species, but resistance can emerge during therapy 3
- Chloramphenicol, tetracycline, and trimethoprim-sulfamethoxazole are extremely active against all three Aeromonas species 2
- Quinolones, such as ciprofloxacin, are effective against Aeromonas hydrophila and can be used to treat Aeromonas-associated colitis 4
- Carbapenems, such as imipenem and meropenem, remain highly active against Aeromonas species 5
Specific Treatment Recommendations
- For community-acquired Aeromonas infections, a broad-spectrum cephalosporin, such as cefotaxime, can be used as an antimicrobial alternative 3
- For nosocomial Aeromonas infections, the choice of antibiotic should be based on susceptibility testing, as nosocomial isolates may be less susceptible to certain antibiotics 3
- The combination of beta-lactam and aminoglycoside antibiotics does not demonstrate therapeutic superiority in patients with Aeromonas bacteraemia 3