IDSA Recommendations for Treating Bartonella Infections in HIV-AIDS Preferred Therapy For Bacillary Angiomatosis, Peliosis Hepatis, Bacteremia, and Osteomyelitis: • Doxycycline 100 mg PO or IV q12h (AII), or • Erythromycin 500 mg PO or IV q6h (AII) For Infections Involving the CNS: • Doxycycline 100 mg PO or IV q12h +/- rifampin 300 mg PO or IV q12h (AIII) For Confirmed Bartonella Endocarditis: • (Doxycycline 100 mg IV q12h + gentamicin 1 mg/kg IV q8h) x 2 weeks, then continue with doxycycline 100 mg IV or PO q12h (BII), or • For patients with renal insufficiency: (doxycycline 100 mg IV q12h + rifampin 300 mg IV or PO q12h) x 2 weeks, then continue with doxycycline 100 mg IV or PO q12h (BII) Indication for Long-Term Suppressive Therapy - If a relapse occurs after a ≥3 month course of primary treatment: • A macrolide or doxycycline as long as the CD4 count remains <200 cells/mm3 #Bartonella #Bartonellosis #IDSA #Prevention #Treatment #management #opportunistic #infections #HIVAIDS #pharmacology
