title: Antibiotic therapy for acute Q fever in The Netherlands in 2007 and 2008 and its relation to hospitalization.
abstract: Data about the effectiveness of different antibiotic regimens for the treatment of acute Q fever from clinical studies is scarce. We analysed the antibiotic treatment regimens of acute Q fever patients in 2007 and 2008 in The Netherlands and assessed whether hospitalization after a minimum of 2 days antibiotic therapy was related to the initial antibiotic therapy. Clinical data on antibiotic treatment and risk factors of acute Q fever patients were obtained from general practitioner medical records and self-reported by patients. For the 438 study patients, doxycycline was the most commonly prescribed initial antibiotic in both study years. After adjustments for confounding factors, doxycycline (200 mg/day), moxifloxacin, as well as other possibly effective antibiotics [including other new fluoroquinolones and doxycycline (100 mg/day)] showed significant lower risks for hospitalization compared to β-lactam antibiotics and azithromycin (reference group), with the lowest risk for doxycycline (200 mg/day) (odds ratio 0·04, 95% confidence interval 0·01-0·22). These data support current guidelines that recommend doxycycline as the first choice antibiotic for treating acute Q fever.
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and Environment, Bilthoven, The Netherlands. frederika.dijkstra@rivm.nl
authors.forename: F
authors.initials: F
authors.lastname: Dijkstra
authors.forename: J
authors.initials: J
authors.lastname: Riphagen-Dalhuisen
authors.forename: N
authors.initials: N
authors.lastname: Wijers
authors.forename: E
authors.initials: E
authors.lastname: Hak
authors.forename: M A B
authors.initials: MA
authors.lastname: Van der Sande
authors.forename: G
authors.initials: G
authors.lastname: Morroy
authors.forename: P M
authors.initials: PM
authors.lastname: Schneeberger
authors.forename: B
authors.initials: B
authors.lastname: Schimmer
authors.forename: D W
authors.initials: DW
authors.lastname: Notermans
authors.forename: W
authors.initials: W
authors.lastname: Van der Hoek
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011778:Q Fever / Q000188:drug therapy* / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D004318:Doxycycline