Which antibiotic is listed as a treatment for plague (Yersinia pestis)?

Which antibiotic is listed as a treatment for plague (Yersinia pestis)?

• A. Ciprofloxacin
• B. Gentamicin
• C. Doxycycline
• D. Azithromycin

Answer: (B)

Plague requires a fast-acting, bactericidal antibiotic that reaches the bacteria quickly. Gentamicin, an aminoglycoside, fits this need well because it rapidly kills Yersinia pestis by inhibiting protein synthesis (binding to the 30S ribosomal subunit), which makes it a standard, guideline-supported treatment for plague. It’s commonly used IV for systemic infection and has a long track record of effectiveness in bubonic and pneumonic forms, improving survival when started promptly. Among the listed options, gentamicin is the one most consistently recommended as a primary therapy for plague in clinical guidelines and textbooks. Doxycycline and ciprofloxacin are acceptable alternatives in some situations (for mild disease or when gentamicin isn’t suitable), but they aren’t the premier first-line choice in many settings. Azithromycin lacks robust evidence for plague treatment and is not considered a standard option. Be mindful of gentamicin’s potential toxicity, especially kidney and ear toxicity, so renal function and drug levels are monitored as needed.

Plague requires a fast-acting, bactericidal antibiotic that reaches the bacteria quickly. Gentamicin, an aminoglycoside, fits this need well because it rapidly kills Yersinia pestis by inhibiting protein synthesis (binding to the 30S ribosomal subunit), which makes it a standard, guideline-supported treatment for plague. It’s commonly used IV for systemic infection and has a long track record of effectiveness in bubonic and pneumonic forms, improving survival when started promptly.

Among the listed options, gentamicin is the one most consistently recommended as a primary therapy for plague in clinical guidelines and textbooks. Doxycycline and ciprofloxacin are acceptable alternatives in some situations (for mild disease or when gentamicin isn’t suitable), but they aren’t the premier first-line choice in many settings. Azithromycin lacks robust evidence for plague treatment and is not considered a standard option.

Be mindful of gentamicin’s potential toxicity, especially kidney and ear toxicity, so renal function and drug levels are monitored as needed.