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The efficacies of ceftriaxone, cefepime, doxycycline, ciprofloxacin, and combination therapy were assessed in<jats:named-content content-type=\"genus-species\">V. vulnificus<\/jats:named-content>intestinal infection in mice in order to model foodborne infections. In accordance with prior studies of cefotaxime, cefepime was synergistic with doxycycline and ciprofloxacin<jats:italic>in vitro<\/jats:italic>; combination therapy significantly decreased bacterial growth, by \u22652 log<jats:sub>10<\/jats:sub>units, from that with antibiotic monotherapy (<jats:italic>P<\/jats:italic>&lt; 0.01).<jats:italic>In vivo<\/jats:italic>, survival rates in the ceftriaxone (50%), doxycycline (79%), and ciprofloxacin (80%) groups were significantly higher than those in the control group (0%) (<jats:italic>P<\/jats:italic>&lt; 0.0001). Survival was significantly higher with ceftriaxone-doxycycline (91%) or ceftriaxone-ciprofloxacin (100%) therapy than with ceftriaxone (50%) (<jats:italic>P<\/jats:italic>\u2264 0.05). Survival with cefepime-doxycycline (96%) or cefepime-ciprofloxacin (90%) therapy was significantly higher than that with cefepime alone (20%) (<jats:italic>P<\/jats:italic>&lt; 0.001). There was no difference in survival between the combination therapy groups. Thus, we conclude that combination therapy was the most effective treatment for foodborne<jats:named-content content-type=\"genus-species\">V. vulnificus<\/jats:named-content>septicemia. In a septic patient with a recent ingestion of raw seafood, cefepime in combination with doxycycline or ciprofloxacin should be initiated for coverage of resistant Gram-negative organisms and<jats:named-content content-type=\"genus-species\">V. vulnificus<\/jats:named-content>pending a microbiological diagnosis. Once a diagnosis of foodborne<jats:named-content content-type=\"genus-species\">V. vulnificus<\/jats:named-content>septicemia is established, treatment can safely transition to ceftriaxone in combination with doxycycline or ciprofloxacin.<\/jats:p>","DOI":"10.1128\/aac.01106-17","type":"journal-article","created":{"date-parts":[[2017,10,3]],"date-time":"2017-10-03T00:30:26Z","timestamp":1506990626000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":44,"title":["Efficacy of Ceftriaxone, Cefepime, Doxycycline, Ciprofloxacin, and Combination Therapy for Vibrio vulnificus Foodborne Septicemia"],"prefix":"10.1128","volume":"61","author":[{"given":"Sonya A.","family":"Trinh","sequence":"first","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Department of Medicine, Division of Infectious Diseases, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8080-7485","authenticated-orcid":false,"given":"Hannah E.","family":"Gavin","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Department of Microbiology-Immunology, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3274-7611","authenticated-orcid":false,"given":"Karla J. 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