What is the first-line treatment for a pregnant patient diagnosed with Rocky Mountain spotted fever?

In the case of a pregnant patient diagnosed with Rocky Mountain spotted fever, the first-line treatment is chloramphenicol. This choice is based on the need to avoid potential harm to the developing fetus while ensuring effective treatment for the mother.

Doxycycline, though commonly used as a first-line treatment in non-pregnant patients, is contraindicated in pregnancy due to its association with tooth discoloration and potential bone development issues in the fetus. Other options such as azithromycin and amoxicillin are not considered effective against Rocky Mountain spotted fever, which is caused by the Rickettsia rickettsii bacterium. Chloramphenicol is the preferred choice in pregnancy because it has been shown to be effective and has a longer history of use in pregnant women with infections caused by various Rickettsiae, thus balancing the risks and benefits appropriately.

Always consult current guidelines and clinical judgment when managing infections in pregnant patients, especially with conditions like Rocky Mountain spotted fever.