Treatment

Before considering treatment, the first step is to make sure the diagnosis is correct.

Effective treatments are available, and most people who are infected with Babesia microti respond well. People who do not have any symptoms or signs of babesiosis usually do not need to be treated.

Health care providers may consult with CDC staff about whether to treat someone who has babesiosis, what type(s) of therapy to use, how to monitor the status of the infection, and how long to treat. Treatment decisions should be individualized, especially for people who have (or are at risk for) severe or relapsing infection.

In general, babesiosis usually is treated for at least 7-10 days with a combination of two prescription medications – typically either:

• atovaquone PLUS azithromycin; OR
• clindamycin PLUS quinine (this combination is the standard of care for severely ill patients).

Some patients—including those with severe illness—might require or benefit from supportive care, such as:

• antipyretics (to decrease fever);
• vasopressors (to increase the blood pressure, if it is low and unstable);
• blood transfusions;
• exchange transfusions (in which portions of a patient’s blood or blood cells are replaced with transfused blood products);
• mechanical ventilation (if patients have trouble breathing on their own); or
• dialysis (if their kidneys stop working normally).