Ciprofloxacin for treatment of tularemia in children

Pediatr Infect Dis J. 2000 May;19(5):449-53. doi: 10.1097/00006454-200005000-00011.


Background: Children with tularemia are, irrespective of severity of disease, usually subjected to parenteral treatment with aminoglycosides. Based on available susceptibility testing, quinolones might be effective oral alternatives of parenteral therapy. These drugs cause arthropathy in immature animals, but this risk is currently regarded to be low in humans.

Patients and methods: In 12 patients (median age, 4 years; range, 1 to 10) with ulceroglandular tularemia, a 10- to 14-day course of oral ciprofloxacin, 15 to 20 mg/kg daily in 2 divided doses, was prescribed. Microbiologic investigations included identification of the infectious agent by PCR and culture of wound specimens, as well as determination of antibiotic susceptibility of isolates of Francisella tularensis.

Results: Defervescence occurred within 4 days of institution of oral ciprofloxacin in all patients. After a median period of 4.5 days (range, 2 to 24), the patients were capable of outdoor activities. In 2 cases, treatment was withdrawn after 3 and 7 days because of rash. In both cases a second episode of fever occurred. All children recovered without complications. In 7 cases F. tularensis was successfully cultured from ulcer specimens and tested for susceptibility to ciprofloxacin. MIC values for all isolates were 0.03 mg/l.

Conclusion: In our sample of 12 patients ciprofloxacin was satisfactory for outpatient treatment of tularemia in children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Anti-Infective Agents / adverse effects
  • Anti-Infective Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Ciprofloxacin / adverse effects
  • Ciprofloxacin / therapeutic use*
  • Female
  • Francisella tularensis / drug effects
  • Francisella tularensis / genetics
  • Francisella tularensis / isolation & purification
  • Humans
  • Infant
  • Male
  • Microbial Sensitivity Tests
  • Polymerase Chain Reaction
  • Treatment Outcome
  • Tularemia / drug therapy*
  • Tularemia / epidemiology
  • Tularemia / microbiology


  • Anti-Infective Agents
  • Ciprofloxacin