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Tytuł:
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Comparison of doxycycline-streptomycin, doxycycline-rifampin, and ofloxacin-rifampin in the treatment of brucellosis: a randomized clinical trial.
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Autorzy:
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Hashemi SH; Department of Infectious Diseases, Hamedan University of Medical Sciences, Hamedan, Iran.
Gachkar L
Keramat F
Mamani M
Hajilooi M
Janbakhsh A
Majzoobi MM
Mahjub H
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Źródło:
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International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2012 Apr; Vol. 16 (4), pp. e247-51. Date of Electronic Publication: 2012 Jan 30.
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Typ publikacji:
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Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Hamilton, ON : Elsevier
Original Publication: Hamilton, ON : Decker, c1996-
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MeSH Terms:
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Anti-Bacterial Agents/*therapeutic use
Brucellosis/*drug therapy
Doxycycline/*therapeutic use
Ofloxacin/*therapeutic use
Rifampin/*therapeutic use
Streptomycin/*therapeutic use
Adult ; Brucella melitensis/isolation & purification ; Brucellosis/microbiology ; Drug Therapy, Combination ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Treatment Outcome ; Young Adult
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Substance Nomenclature:
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0 (Anti-Bacterial Agents)
A4P49JAZ9H (Ofloxacin)
N12000U13O (Doxycycline)
VJT6J7R4TR (Rifampin)
Y45QSO73OB (Streptomycin)
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Entry Date(s):
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Date Created: 20120203 Date Completed: 20120703 Latest Revision: 20220321
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Update Code:
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20240104
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DOI:
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10.1016/j.ijid.2011.12.003
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PMID:
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22296864
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Background: Traditional regimens for the treatment of brucellosis are associated with significant relapse rates. The aim of this study was to compare the efficacy of ofloxacin plus rifampin (OFX-RIF) versus doxycycline plus streptomycin (DOX-STR) and doxycycline plus rifampin (DOX-RIF) regimens in the treatment of brucellosis.
Methods: Two hundred and nineteen patients with brucellosis were enrolled in a randomized clinical trial; 28 cases were withdrawn because they did not attend the follow-up. Out of 191 patients with brucellosis, 64 received OFX-RIF, 62 received DOX-RIF, and 65 patients received DOX-STR regimens. All patients were assessed during the period of therapy in the second, fourth, and sixth weeks by clinical course and were also followed up clinically and serologically for 6 months after the cessation of therapy.
Results: The highest clinical response (95.4%) was observed in the DOX-STR group (p=0.009). The results of multivariate analysis indicate that treatment with DOX-STR had the least therapeutic failures among the three groups (p=0.033). Adverse reactions were seen in 16.8% of patients, but there was no significant difference among the three groups (p=0.613). The lowest relapse rate (4.6%) was observed in the DOX-STR group (p=0.109).
Conclusions: We conclude that the DOX-STR combination should remain the first-line regimen for the treatment of brucellosis in our region; we recommend DOX-RIF and OFX-RIF combinations as the second-line regimens.
(Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
