Correlation between serum doxycycline concentrations and serologic evolution in patients with Coxiella burnetii endocarditis.
The recommended treatment for Q fever endocarditis is a combination of doxycycline and hydroxychloroquine. We found a correlation between serum doxycycline concentrations and decreases in levels of phase 1 Coxiella burnetii antibodies, in 24 patients with Q fever endocarditis. Patients who had a >2-fold decrease in levels of phase 1 antibodies had serum doxycycline concentrations higher than those of the other patients (mean+/-SD, 5.29+/-1.75 vs. 3.14+/-1.40 microg/mL; P=.003). We recommend adjusting the posology of doxycycline to achieve a serum concentration of at least 5 microg/mL.
Unité des Rickettsies, Centre National de Recherche Scientifique, Unité Mixte de Recherche 6020, Institut Fédératif de Recherche 48, Faculté de Médecine, Université de la Méditerranée, Marseille, France.
J M
JM
Rolain
M N
MN
Mallet
D
D
Raoult
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000097:blood* / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D016997:Coxiella burnetii / Q000254:growth & development* / Q000276:immunology; D004318:Doxycycline / Q000097:blood* / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000097:blood* / Q000188:drug therapy / Q000276:immunology; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D011778:Q Fever / Q000097:blood* / Q000188:drug therapy / Q000276:immunology
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D006886:Hydroxychloroquine; D004318:Doxycycline