Therapeutic options

Since overt listeriosis occurs mainly in immunocompromised persons it is quite consistent to try to restore the hampered defence system by supportive measurements. For direct antimicrobial treatment a series of different antibiotics is available, since Listeria strains isolated from patients are in general susceptible to a wide range of antibiotics, except fosfomycin, quinolones and cephalosporins of the third generation, although a few exceptional strains exist. Unfortunately, most antibiotics are not bactericidal for Listeria . Drug combinations may exert a synergistic effect. Furthermore, the efficacy of therapy is limited by the fact of intracellular habitat of pathogenic Listeria . Few agents, such as macrolides and quinolones, are accumulated within host cells and may attack the intracellular Listeriae . The clinical experience shows that the combination of amoxicillin and gentamicin is the best option.