عند فشل العلاج المضاد للحيوانات التوافقي الأولي في الوَهَن الوعائي العصوي الشديد مع عدوى بارتونيلا متعددة البؤر أو التدهور السريري

References

• For severe Bartonella infections (i.e., patients with multifocal disease or evidence of clinical decompensation), combination therapy using erythromycin or doxycycline with a rifamycin class antibiotic is recommended (BIII); intravenous therapy may be needed initially (AIII).
• Among patients who fail to respond to initial treatment, switching to a different preferred regimen (for example, from doxycycline to erythromycin) may be considered, again with treatment duration of ≥3 months (AIII).
• For severe infections, the addition of a rifamycin class antibiotic is indicated (AIII).