COMPARISON OF THE EFFICACY OF A FOUR-WEEK ANTIMICROBIAL THERAPY WITH WHO RECOMMENDED STANDARD SIX-WEEK DRUG REGIMEN IN THE TREATMENT OF BRUCELLOSIS.

Naghili, B and Taghizadeh, S and Azimi, G and Baiatmakoo, Z (2011) COMPARISON OF THE EFFICACY OF A FOUR-WEEK ANTIMICROBIAL THERAPY WITH WHO RECOMMENDED STANDARD SIX-WEEK DRUG REGIMEN IN THE TREATMENT OF BRUCELLOSIS. J Urmia Univ Med Sci., 22 (4). pp. 364-368.

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Abstract

Brucellosis is a common zoonosis. A large number of cases due to Brucella Melitensis are reported every year in the Mediterranean littoral, the Middle East and some parts of Latin America. The optimal time of antibiotic treatment in patients with brucellosis is unclear. WHO expert committee on brucellosis has recommended streptomycin a doxycycline for at least 6 weeks as the choice regimen. However, some studies suggest short course therapy. This study was aimed to show the efficacy of a four-week antimicrobial therapy instead of relapse rates in two regimens. Materials & Methods: In an acute double blind random study, the patients of brucellosis were divided into two equal groups. One group received a four-week drug regimen (3 weeks streptomycin + 4 weeks Doxycycline). The other group had a six week antibiotic regimen including 2 week's streptomycin + 6 weeks Doxycyxline). The patients with complicated brucellosis were excluded. The criteria for diagnosis of patients were serologic tests (STA) so in patients who met the clinical and laboratory signs, the relapse was evaluated bases on clinical and serologic indicators. Results: The mean age of the patients was 38.83 ± 19.99 years. A significant difference was noted between the age of patients and the number of relapses and with increasing age, relapses were greater (P=0.022). In our review we had eight cases of relapses in a four-week therapy while three cases with relapses were found in the later group and the difference was significant (P=0.044). Conclusion: Doxycycline-streptomycin for six weeks is still a better treatment of brucellosis, on the condition that relapses rate and early response to treatment is considered.

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