From the Guidelines
Azithromycin is the recommended treatment for Cat Scratch Disease (CSD).
Treatment Details
- The recommended dose of azithromycin for patients weighing ≥45.5 kg is 500 mg on day 1, then 250 mg once daily for 4 additional days; for those weighing <45.5 kg, the dose is 10 mg/kg orally on day 1, then 5 mg/kg on days 2–5 1.
- This treatment regimen is based on a double-blind placebo-controlled study that showed significant reduction in lymph node size in azithromycin-treated patients compared to placebo 1.
- Although other antibiotics such as penicillin and amoxicillin have been suggested as rational options for cutaneous infection 1, azithromycin is the preferred choice due to its efficacy and recommended dosing protocol 1.
Key Points
- Cat Scratch Disease is typically caused by Bartonella henselae in immunocompetent hosts.
- The disease course varies, but lymphadenopathy generally resolves within 1–6 months.
- Extranodal disease and suppurative nodes are possible complications, but rare.
From the Research
Treatment Options for Cat Scratch Disease (CSD)
The treatment for Cat Scratch Disease (CSD) varies depending on the severity of the disease.
- For patients with severe CSD, antibiotic therapy can be considered 2, 3, 4.
- The most effective antibiotics for CSD are:
Conservative Treatment
- For the majority of patients with mild or moderate CSD, conservative, symptomatic treatment is recommended 2, 6.
- Most cases of CSD are self-limiting and do not require antibiotic treatment 4, 5.
- Treatment with trimethoprim-sulphamethoxazole, ciprofloxacin, or azithromycin is recommended for complicated CSD, with gentamicin being reserved for severely ill patients 4.