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Antibiotic therapy as prevention and treatment of Q fever
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Clay, Katherine Ann (2019) Antibiotic therapy as prevention and treatment of Q fever. PhD thesis, University of Warwick.
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Official URL: http://webcat.warwick.ac.uk/record=b3490005~S15
Abstract
Q fever was first identified as a problem for the military during World War 2 when thousands of troops were affected(1). British military personnel developed Q fever during the recent campaign in Afghanistan, which in approximately 20% of cases led to Q fever fatigue syndrome (QFS), and in some cases resulted in discharge from military service. This highlighted the requirement to prevent disease acquisition or reduce the severity of disease in order to limit progression to QFS.
Q fever is caused by the intracellular Gram-negative bacterium, Coxiella burnetii. Novel in vitro and in vivo experiments were conducted to evaluate the efficacy of a range of antibiotics readily accessible to the military against C. burnetii. The benefit of using doxycycline, levofloxacin, ciprofloxacin and co-trimoxazole as chemoprophylaxis and treatment were assessed in two in vivo models of infection. Analysis of the data from a military Q fever patient cohort was analysed in order to identify any factors that might predict progression to QFS in an acute Q fever patient.
The results suggest that antibiotic initiation around the time of symptom onset following exposure to C. burnetii provides the optimum outcome in the AJ mouse model. Chemoprophylaxis does not appear to improve the outcome in these studies, leading instead to a prolonged incubation period and either relapse or dissemination of disease after antibiotics are stopped. From analysis of the patient data it appears that initiation of doxycycline greater than five days after symptom onset may be associated with progression to QFS.
In conclusion, the studies conducted suggest that to improve the clinical outcome for future Q fever patients, timely diagnosis and early treatment at the point of symptom onset needs to be achieved. It is suggested that this will reduce symptom duration, disease severity and the likelihood of developing long term fatigue.
Item Type: | Thesis (PhD) | ||||
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Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine |
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Library of Congress Subject Headings (LCSH): | Q fever -- Treatment, Antibiotics, Ciprofloxacin | ||||
Official Date: | June 2019 | ||||
Dates: |
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Institution: | University of Warwick | ||||
Theses Department: | Warwick Medical School | ||||
Thesis Type: | PhD | ||||
Publication Status: | Unpublished | ||||
Supervisor(s)/Advisor: | McCarthy, Noel D. ; Bailey, Mark, Lt. Col. ; Norville, Isobel | ||||
Format of File: | |||||
Extent: | vii, 235 leaves : illustrations (chiefly color) | ||||
Language: | eng |
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