Treatment of human brucellosis

Human brucellosis is a multisystem disease that may present with a broad spectrum of clinical manifestations. The primary goals of therapy for brucellosis are to improve the symptoms, reduce complications and prevent relapses. The choice of a regimen and duration of antimicrobial therapy should be based on the location of the disease and the underlying conditions. The regimen of choice is a combination therapy with doxycycline for 45 days and streptomycin for 14 days. A second-choice consists of a combination of doxycycline and rifampin for 45 days. Children under 8 years old and pregnant women should not be treated with tetracyclines. In children under 8 years old, the preferred regimen is rifampin with cotrimoxazole or gentamicin. Rifampin (900 mg once daily for 6 weeks) is considered the drug of choice for treating brucellosis in pregnant women. Surgery should be considered for patients with endocarditis, cerebral, epidural or splenic abscess or other abscesses, which are resistant to antibiotics.