From the Guidelines
Listeria myositis should be treated with ampicillin plus gentamicin as the first-line therapy, as recommended by the Infectious Diseases Society of America 1. This approach is based on the guidelines for the management of bacterial infections, including Listeria monocytogenes. The recommended treatment involves administering ampicillin (2g IV every 4 hours) in combination with gentamicin (1-1.5 mg/kg IV every 8 hours) for a synergistic effect.
- Key considerations for treatment include:
- Duration of treatment: typically 2-3 weeks for uncomplicated cases and 3-6 weeks for severe infections or those with complications
- Alternative therapy for penicillin-allergic patients: trimethoprim-sulfamethoxazole (TMP-SMX) is the preferred alternative, as stated in the guidelines 1
- Importance of prompt treatment: Listeria myositis can be life-threatening, with mortality rates of 20-30% if untreated, emphasizing the need for early intervention
- Supportive care: pain management, hydration, and monitoring for complications such as compartment syndrome are crucial during treatment
- Patient populations at higher risk for Listeria myositis include:
- Immunocompromised individuals
- Pregnant women
- Elderly people
- Those with underlying conditions
- Diagnostic approaches may involve:
- Blood cultures
- Muscle biopsy
- Clinical presentation: fever, muscle pain, weakness, and elevated creatine kinase levels
From the FDA Drug Label
Ampicillin for Injection, USP is indicated in the treatment of infections caused by susceptible strains of the designated organisms in the following conditions: ... Bacterial Meningitis caused by E. coli, Group B Streptococci, and other Gram-negative bacteria (Listeria monocytogenes, N. meningitidis).
The FDA drug label does not answer the question about listeria myositis.
From the Research
Listeria Myositis
- Listeria myositis is not explicitly mentioned in the provided studies, however, the studies discuss various aspects of Listeria infections, including treatment options and clinical manifestations.
- The studies focus on listeriosis, a food-borne illness caused by Listeria monocytogenes, which can lead to severe infections, including sepsis, meningitis, and rhombencephalitis, particularly in immunocompromised hosts 2, 3.
- Treatment options for listeriosis include ampicillin alone or in combination with gentamicin, which remains the treatment of choice 2, 4.
- Alternative therapies, such as trimethoprim/sulfamethoxazole, erythromycin, vancomycin, and fluoroquinolones, may be used in cases of allergies or certain disease states 2, 5.
- The mortality rate for listeriosis is high, highlighting the importance of effective antibiotic treatment and prompt diagnosis 3, 5.
- Gentamicin combination treatment has been associated with lower mortality rates in patients with invasive listeriosis 4.
- The epidemiology and clinical manifestations of Listeria monocytogenes infection are complex, and further study is needed to determine the best treatment approaches for different patient populations 3, 5.