Current therapeutic strategy in spinal brucellosis.

Area of Science:

• Infectious Diseases
• Orthopedics
• Public Health

Background:

• Brucellosis is a systemic infection with frequent musculoskeletal complications, particularly affecting the spine.
• Spinal brucellosis is a destructive condition often seen in elderly patients, necessitating prompt diagnosis and intervention.
• Optimal treatment duration and regimens for spinal brucellosis remain debated, with ongoing relapses and sequelae.

Purpose of the Study:

• To review the current understanding and management strategies for spinal brucellosis.
• To discuss the established and alternative antimicrobial therapies for spinal brucellosis.
• To highlight the importance of early diagnosis and appropriate treatment to improve patient outcomes.

Main Methods:

• Literature review of studies on spinal brucellosis treatment.
• Analysis of classical and alternative antimicrobial regimens.
• Evaluation of treatment outcomes, including relapse rates and adverse effects.

Main Results:

• The classical regimen of doxycycline and streptomycin is the primary choice for spinal brucellosis.
• Alternative therapies like rifampin, fluoroquinolones, and co-trimoxazole are considered for specific patient populations.
• Relapses and sequelae underscore the need for continued research into optimal treatment protocols.

Conclusions:

• Early diagnosis and prompt treatment are crucial for managing spinal brucellosis effectively.
• The doxycycline-streptomycin combination remains the gold standard, but alternative regimens are vital for managing contraindications or treatment failures.
• Further research is needed to refine treatment strategies and minimize long-term complications of spinal brucellosis.