Treatment of listeriosis.

OBJECTIVE: To review the most currently accepted treatment options for the treatment of listeriosis.

DATA SOURCES: Clinical literature was accessed through MEDLINE (1966-October 1999). Key search terms included Listeria monocytogenes, food-borne illness, penicillins, fluoroquinolones, cephalosporins, and vancomycin.

DATA SYNTHESIS: Listeriosis is mainly a food-borne illness caused by L. monocytogenes; people most prone to the disease are pregnant women, newborns, elderly, and those with HIV or other diseases compromising immunity. Listeria infections are associated with a high mortality rate, and thus effective antibiotic treatment is essential. Although a variety of antibiotics have activity against the organism, ampicillin alone or in combination with gentamicin remains the treatment of choice. Some patients may require alternative therapies due to allergies or certain disease states. Second-line agents for these cases include trimethoprim/sulfamethoxazole, erythromycin, vancomycin, and the fluoroquinolones. Cephalosporins are not active against Listeria.

CONCLUSIONS: Ampicillin is currently the drug of choice for treating L. monocytogenes infections. Many antibiotics have been shown to be effective and are used as second-line agents. However, further study is required for some of the most recently introduced antibiotics, such as the fluoroquinolones, to determine their place in the treatment of Listeria infections.