What is the treatment of choice for Rocky Mountain Spotted Fever?

Doxycycline is the treatment of choice for Rocky Mountain Spotted Fever (RMSF), primarily due to its effectiveness against the obligate intracellular bacterium Rickettsia rickettsii, which causes the disease. This antibiotic is part of the tetracycline class and is particularly advantageous in this context because it has excellent tissue penetration and can reach the intracellular environments where Rickettsia resides.

The prompt initiation of treatment is crucial in RMSF, as delays can lead to severe illness or even fatal outcomes. Doxycycline not only reduces the duration of symptoms but also significantly decreases the risk of complications associated with the infection. Its ability to be administered effectively in children and pregnant women, along with a relatively favorable side effect profile, makes it the preferred choice in clinical practice.

While minocycline and tetracycline are members of the same class, doxycycline is more commonly used due to its pharmacokinetic properties and broader spectrum of activity against Rickettsial infections. Clindamycin is not indicated for RMSF because it is ineffective against the causative organism and does not possess the necessary properties to treat this specific infection effectively.