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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
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Published on: May 23, 2021

Antibiotics for treating human brucellosis.

Reza Yousefi-Nooraie1, Sameh Mortaz-Hejri, Mehdi Mehrani

  • 1Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. yousefr@mcmaster.ca.

The Cochrane Database of Systematic Reviews
|October 19, 2012
PubMed
Summary

Doxycycline plus streptomycin is more effective for treating brucellosis than doxycycline plus rifampicin. However, treatment choice depends on access to care and cost due to streptomycin

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Area of Science:

  • Infectious Diseases
  • Bacteriology
  • Pharmacology

Background:

  • Brucellosis is a prevalent global zoonotic infection.
  • Current antibiotic regimens for human brucellosis show inconsistencies.
  • A systematic review is needed to guide clinical practice and research.

Purpose of the Study:

  • To systematically review antibiotic regimens for human brucellosis.
  • To evaluate monotherapy versus combination antibiotic treatments.
  • To assess treatment effectiveness and adverse effects.

Main Methods:

  • Searched multiple databases (Cochrane, MEDLINE, EMBASE, LILACS) and conference abstracts until May 2012.
  • Included randomized controlled trials (RCTs) for acute, chronic, complicated, and uncomplicated brucellosis.
  • Extracted data on relapse, symptom persistence, and adverse drug effects; pooled homogenous studies using meta-analysis.

Main Results:

  • Doxycycline plus streptomycin showed higher effectiveness than doxycycline plus rifampicin, with fewer treatment failures and relapses.
  • Quinolone plus rifampicin demonstrated similar effectiveness to doxycycline plus rifampicin but was better tolerated.
  • Limited data and heterogeneity affected conclusions for other comparisons.

Conclusions:

  • Doxycycline (6 weeks) plus streptomycin (2-3 weeks) is a more effective regimen than doxycycline plus rifampicin (6 weeks).
  • Daily intramuscular streptomycin necessitates consideration of access to care and cost.
  • Quinolone plus rifampicin offers comparable effectiveness to doxycycline plus rifampicin with better tolerability.