How frequently do patients experience clinical relapses of disease following 1 year of treatment of Whipples disease?
Because Whipple’s disease is uncommon, formal prospective studies of therapeutic regimens have not been carried out. It is estimated that up to 35% of patients with Whipple’s disease who had long-term treatment relapsed after an average of 5 years. Neurologic relapses are most common and are particularly hard to treat. More long-term data are needed regarding the choice and duration of antibiotic therapy. Recommendations for treating disease relapses include ceftriaxone (2 g IV twice daily) or penicillin G 4 MU IV every 4 hours for 4 weeks, followed by doxycycline (100 mg twice daily) plus hydroxychloroquine (200 mg three times daily or TMP/sulfa (160 mg/800 mg twice per day) for a year.