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Treatment of a suspected case of plague with antibiotics should be started as early as possible, without waiting for laboratory confirmation. Immediate treatment with antibiotics has dramat-ically reduced mortality due to the disease. Streptomycin, doxycy-cline, and chloramphenicol are used effectively for treatment of plague. Treatment with antibiotics is usually given for a duration of 10 days. A two-drug regimen should be used in severe cases. Streptomycin is the drug of choice to treat plague. Doxycycline is given in patients who are allergic to streptomycin or who cannot tolerate streptomycin. Chloramphenicol is the drug of choice in septicemic plague or for patients with hypotension. In patients with hypotension, intramuscularly administered streptomycin may be poorly absorbed. Resistance of Y. pestis to streptomycin, gentamicin, doxycycline, and chloramphenicol is very rare.
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