Yersinia enterocolitis

Yersinia enterocolitica causes a spectrum of disease that includes acute enterocolitis and extraintestinal disease (eg mesenteric adenitis or pharyngitis with or without diarrhoea). It is usually foodborne.

The mainstay of therapy for Yersinia enterocolitis is rehydration. Antimicrobial therapy for Yersinia enterocolitis in patients who are immunocompetent has not been shown to be beneficial. Most acute infections are self-limiting and antibiotics are not indicated.

For patients with immune compromise, extraintestinal disease, or Yersinia enterocolitis with symptoms not improving after 2 weeks, use:

1ciprofloxacin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, 12-hourly for 5 days12. For dosage adjustment in adults with kidney impairment, see ciprofloxacin oral dosage adjustment ciprofloxacin ciprofloxacin ciprofloxacin

OR

1norfloxacin 400 mg (child 6 months or older: 10 mg/kg up to 400 mg) orally, 12-hourly for 5 days34. For dosage adjustment in adults with kidney impairment, see norfloxacin dosage adjustment norfloxacin norfloxacin norfloxacin

OR

1trimethoprim+sulfamethoxazole 160+800 mg (child 1 month or older: 4+20 mg/kg up to 160+800 mg) orally, 12-hourly for 5 days. For dosage adjustment in adults with kidney impairment, see trimethoprim+sulfamethoxazole dosage adjustment. trimethoprim + sulfamethoxazole trimethoprim+sulfamethoxazole trimethoprim+sulfamethoxazole

Y. enterocolitica bacteraemia is usually treated with a prolonged course of ciprofloxacin (3 weeks). Moderate- and broad-spectrum cephalosporins, doxycycline, and trimethoprim+sulfamethoxazole have also been used, but treatment failures have been reported.

1 Ciprofloxacin is not licensed for use in children on the basis of animal studies that showed an adverse effect on cartilage development with quinolone use; however, clinical trial data suggest that adverse musculoskeletal events are usually mild and short term, similar to those observed in adults. Ciprofloxacin can be used in children when it is the drug of choice.Return
2 An oral liquid formulation of ciprofloxacin is not commercially available; for formulation options for children or people with swallowing difficulties, see Don’t Rush to Crush, which is available for purchase from the Advanced Pharmacy Australia website or through a subscription to eMIMSplus.Return
3 Norfloxacin is not licensed for use in children on the basis of animal studies that showed an adverse effect on cartilage development with quinolone use; however, clinical trial data suggest that adverse musculoskeletal events are usually mild and short term, similar to those observed in adults. Norfloxacin can be used in children when it is the drug of choice.Return
4 An oral liquid formulation of norfloxacin is not commercially available; for formulation options for children or people with swallowing difficulties, see Don’t Rush to Crush, which is available for purchase from the Advanced Pharmacy Australia website or through a subscription to eMIMSplus.Return