Whipple’s Disease: Drug Therapy

Therapeutic target

• Rehydration (fluid balance).
• Elimination of bacteria
• Avoidance of complications

Therapy recommendations

• Symptomatic therapy (analgesics (painkillers)/antipretics(antipyretic drugs) if necessary) including fluid replacement, i.e., oral rehydration for signs of dehydration (fluid deficiency; >3% weight loss): administration of oral rehydration solutions (ORL), which should be hypotonic, between meals (“tea breaks”) for mild to moderate dehydration.
• Antibiosis (antibiotic therapy):
  • Initial therapy with ceftriaxone (cephalosporins) or meropenem (carbapenems) for 2 weeks.
  • Maintenance therapy: cotrimoxazole (trimethoprim + sulfamethoxazole) or tetracyclines for 1 year.
• Before therapy, be sure to perform PCR (polymerase chain reaction) of the CSF! [the antibiotics listed above are compatible with liquor.]
• Control of the success of therapy by Tropheryma whippelii PCR (polymerase chain reaction) from a tissue sample, stool, cerebrospinal fluid (“nerve water“).