Treatment of Vibrio vulnificus Infections
Treatment of the healthy person with mild gastroenteritis is usually supportive, with hydration as the mainstay of treatment. Moderate or severe cases of gastroenteritis should be treated with antibiotics as listed in Table 1.1
Skin and wound infections may spread rapidly, and 35% of patients with wounds may become bacteremic. Therefore, prompt debridement of infected wounds is generally recommended, along with two antibiotics as outlined in Table 2.1 2.
Mortality increases with delays between onset of symptoms and initiation of antibiotic treatment. Therefore, antibiotics should be started immediately and supportive care provided in an intensive care unit (ICU) to minimize effects of septic shock and possible multiple organ failure. Patients with Vibrio septicemia are also prone to development of gastrointestinal bleeding and disseminated intravascular coagulation (DIC). Patients should be monitored closely for development of these conditions, and prophylaxis for gastrointestinal stress ulceration should be considered.2
Antibiotic therapy for septicemia consists of two drug therapy with options for treatment outlined in Table 3.1
- Daniels, N.A., and A. Shafaie. 2000. A review of pathogenic Vibrio infections J Infect Med. 17(10):665-685.
- Morris, J.G. 2003. Vibrio vulnificus infections. UpToDate. (www.uptodate.com).