Most tularemia cases respond to first-line or alternative antimicrobial regimens. When those options are no longer available or appropriate, a distinct set of third-tier agents may be considered under current evidence-based guidance.
This protocol applies when recommended first-line and alternative antimicrobial drugs for tularemia have been exhausted, requiring escalation to specifically designated third-tier options. The clinical decision to use these agents depends on individual patient factors and the availability of other treatments.
When other recommended antimicrobial options for tularemia are exhausted, specific third-tier agents — drawn from more than one drug class — may be brought into consideration. The selection among these agents is guided by patient-specific factors including age and pregnancy status.