Listeriosis
ICD-10 A32 · ICD-11 1C1A

Treatment of Listeria Bacteraemia with Preserved Immunity, No Meningitis or Endocarditis, and No Penicillin Allergy

Clinical Scenario

This protocol covers Listeria bacteraemia in a person with preserved immunity, where there is no evidence of meningitis or endocarditis, and the patient has no allergy to penicillins.

Treatment Approach

The cornerstone of management is high-dose antimicrobial therapy. Ampicillin is the preferred agent; a penicillin-class alternative is considered likely to be similarly effective. The complete regimen — including agent selection, dosing, and treatment duration — is specified in the full protocol.

Full structured regimen with dosing details available via the protocol link below.

Instant Access to Structured Evidence-Based Regimens

References

  1. High dose antimicrobial therapy should be used in all cases of bacteraemia/possible bacteraemia.
  2. Most experts recommend adding gentamicin to ampicillin therapy for the treatment of bacteraemia in persons with impaired immunity (including neonates), and all cases of meningitis and endocarditis.
  3. Ampicillin is the preferred agent, although penicillin is likely to be as effective.
  4. Bacteremic patients without CSF abnormalities can be treated for 2 weeks; meningitis should be treated for 3 weeks; relapses have been documented with shorter durations of therapy.
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