Table 2. Current treatment protocol (WHO and CDC recommendations)*.

Antibiotic	Dose	Duration	Remarks	Way of administration
Streptomycin	15 mg/kg/dose	7 days	Maximum 1 g per day	IM
Gentamycin	5 mg/kg/d	7 days	Once daily	IM or IV
Doxycycline	100 mg/12 h	7 to 10 days	Initially a loading dose of 200 mg/12 h the first day	IV or PO
Tetracycline	2 g/d	7 to 10 days	Initially loading dose of 2 g	IV or PO
Levofloxacin	500 to 750 mg daily	7 to 10 days	Once-daily special indication for high tissue penetration	IV or PO
Ciprofloxacin	400 mg/12 h	7 to 10 days		PO
Chloramphenicol	50 to 100 mg/kg/d	10 days	Indicated in cases for high tissue penetration	IV or PO
			Dose may be reduced to 25 to 30 mg/kg/d depending on clinical response to reduce the risk of bone marrow suppression
Cotrimoxazole	1 g/4–6 h	10 days	Not indicated as first choice	PO
			Initial loading dose of 2–4 g
Approved combinations
Gentamycin + doxycycline	See above
Gentamycin + levofloxacin	See above
Postexposure prophylaxis
Doxycycline	100 mg/12 h			PO
Cotrimoxazole	ND
Ciprofloxacin	500 mg/12 h

Modified from: Mead PS. Yersinia Species (Including Plague). In: Mandell, Douglas, and Bennett's. Principles and practice of infectious diseases, 8th Edition; 2015. pp. 2607–2618 [2].

Abbreviations: CDC, Centers for Disease Control and Prevention; IM, intramuscular; IV, intravenous; ND, not defined; PO, by mouth