Treatment of Streptobacillosis in Adults (Age 18+) with Rat Bite Fever — Non-Penicillin-Allergic

This protocol covers the management of Streptobacillosis (rat bite fever) in adult patients aged 18 years or older who have no history of penicillin allergy.

Clinical Scenario

Adult patient (18 years or older) presenting with rat bite fever, without penicillin allergy. Age is a defining parameter in selecting the appropriate treatment regimen for this infection.

Treatment Approach

Management in this setting centres on an intravenous penicillin-based regimen administered over a defined course. Escalation criteria apply if the initial response is insufficient.

The full regimen — specific agent, dose, duration, and escalation thresholds — is available in the complete protocol.

Treatment Goal

Clinical response with rapid resolution of acute symptoms, assessed within 2 days of initiating therapy.

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References

DOI: 10.1128/CMR.00016-06

Adults with rat bite fever should receive 400,000 to 600,000 IU/day (240 to 360 mg) of intravenous penicillin G for at least 7 days, but this dose should be increased to 1.2 million IU/day (720 mg) if no response is seen within 2 days.

Initiation of an appropriate antibiotic regimen usually precipitates rapid resolution of acute symptoms.

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