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Why is early antibiotic treatment important for plague?

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two plague victims with sores lying in bed, while a robed figure gestures above them. — plague Image depicting victims of the sixth biblical plague.

Early antibiotic treatment is critical for managing plague because it is essential to protect the patient's life and prevent the disease from progressing to more severe, often fatal forms.1

The bacterium Yersinia pestis is highly virulent and capable of rapid multiplication within the host's tissues. If left untreated, the infection can spread from the lymphatic system into the bloodstream, causing septicemic plague, or invade the lungs, resulting in pneumonic plague. These secondary forms are significantly more dangerous; for instance, pneumonic plague is highly infectious and can lead to death within three or four days if medical intervention is not provided.12

By administering antibiotics—such as streptomycin or gentamicin—promptly, the global fatality rate of the disease has been reduced from historical levels of 50–90 percent to less than 15 percent.13