Which regimens are commonly used for pneumonic plague treatment?

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Treat pneumonic plague with a rapid, bactericidal regimen that reaches the lungs and effectively targets Yersinia pestis. The most commonly used approach is an aminoglycoside given intravenously, such as streptomycin or gentamicin, because these drugs provide strong bactericidal activity against the organism and achieve good lung penetration. This is often paired with doxycycline, which adds excellent tissue and intracellular penetration and can be continued orally for step-down therapy once the patient is stabilized. The combination of an aminoglycoside with doxycycline offers robust coverage and helps ensure rapid control of the infection, which is critical in pneumonic plague. Penicillin G alone is not reliable against Y. pestis, and linezolid monotherapy is not a standard first-line treatment. Ciprofloxacin can be used as an alternative in some cases, but the typical, commonly used regimen emphasizes the aminoglycoside plus doxycycline pairing.