Ceftriaxone in the Treatment of Acute and Subacute Human Brucellosis

Al‐Idrissi, Hassan Y.; Uwaydah, Ahmad Kanaan; Danso, K. T.; Qutub, Hatem; Al-Mousa, M. S.

doi:10.1177/030006058901700409

Cited by 22 publications

(8 citation statements)

References 10 publications

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“…Two studies were performed with ceftriaxone [45], [52] in a small number of patients and with poor results. That of Lang [45] was a small comparative study in only 8 patients receiving ceftriaxone, and the treatment failure rate was 75% (6 patients).…”

Section: Resultsmentioning

confidence: 99%

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Systematic Review and Meta-Analysis of Randomized Clinical Trials in the Treatment of Human Brucellosis

Pozo¹,

2012

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BackgroundBrucellosis is a persistent health problem in many developing countries throughout the world, and the search for simple and effective treatment continues to be of great importance.Methods and FindingsA search was conducted in MEDLINE and in the Cochrane Central Register of Controlled Trials (CENTRAL). Clinical trials published from 1985 to present that assess different antimicrobial regimens in cases of documented acute uncomplicated human brucellosis were included. The primary outcomes were relapse, therapeutic failure, combined variable of relapse and therapeutic failure, and adverse effect rates. A meta-analysis with a fixed effect model was performed and odds ratio with 95% confidence intervals were calculated. A random effect model was used when significant heterogeneity between studies was verified.Comparison of combined doxycycline and rifampicin with a combination of doxycycline and streptomycin favors the latter regimen (OR = 3.17; CI95% = 2.05–4.91). There were no significant differences between combined doxycycline-streptomycin and combined doxycycline-gentamicin (OR = 1.89; CI95% = 0.81–4.39). Treatment with rifampicin and quinolones was similar to combined doxycycline-rifampicin (OR = 1.23; CI95% = 0.63–2.40). Only one study assessed triple therapy with aminoglycoside-doxycycline-rifampicin and only included patients with uncomplicated brucellosis. Thus this approach cannot be considered the therapy of choice until further studies have been performed. Combined doxycycline/co-trimoxazole or doxycycline monotherapy could represent a cost-effective alternative in certain patient groups, and further studies are needed in the future.ConclusionsAlthough the preferred treatment in uncomplicated human brucellosis is doxycycline-aminoglycoside combination, other treatments based on oral regimens or monotherapy should not be rejected until they are better studied. Triple therapy should not be considered the current treatment of choice.

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Section: Resultsmentioning

confidence: 99%

“…That of Lang [45] was a small comparative study in only 8 patients receiving ceftriaxone, and the treatment failure rate was 75% (6 patients). Al Idrissi [52] carried out a non-comparative study, also with a very high treatment failure rate (30.8%).…”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Randomized Clinical Trials in the Treatment of Human Brucellosis

Pozo¹,

2012

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“…27,28 Ceftriaxone also offers good in vitro activity and penetration into the CSF. 29 Ceftriaxone alone was given to three patients at onset of disease until defi nite diagnosis. With this antibiotic signs and symptoms abated.…”

Section: Brucellosis Is a Common Endemic Infection In Turkeymentioning

confidence: 99%

Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region

Ceran¹,

Türkoğlu²,

Erdem³

et al. 2011

Braz J Infect Dis

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Brucellosis is a zoonotic infection and has endemic characteristics. Neurobrucellosis is an uncommon complication of this infection. The aim of this study was to present unusual clinical manifestations and to discuss the management and outcome of a series of 18 neurobrucellosis cases. Initial clinical manifestations consist of pseudotumor cerebri in one case, white matter lesions and demyelinating syndrome in three cases, intracranial granuloma in one case, transverse myelitis in two cases, sagittal sinus thrombosis in one case, spinal arachnoiditis in one case, intracranial vasculitis in one case, in addition to meningitis in all cases. Eleven patients were male and seven were female. The most prevalent symptoms were headache (83%) and fever (44%). All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Duration of treatment (varied 3-12 months) was determined on basis of the CSF response. In four patients presented with left mild sequelae including aphasia, hearing loss, hemiparesis. In conclusion, although mortality is rare in neurobrucellosis, its sequelae are signifi cant. In neurobrucellosis various clinical and neuroradiologic signs and symptoms can be confused with other neurologic diseases. In inhabitants or visitors of endemic areas, neurobrucellosis should be kept in mind in cases that have unusual neurological manifestations.

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“…However, in this patient Brucella species was the sole organism isolated. Third generation cephalosporins have been used in the treatment of human brucellosis with variable success [17,18]. However, their role has yet to be determined.…”

Section: Discussionmentioning

confidence: 99%

Brucella Pneumonia: A Case Report

1993

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AH Al-Jam'a, AM Elbashier, SS Al-Faris, Brucella Pneumonia: A Case Report. 1993; 13(1): 74-77 Brucellosis is a classical zoonosis caused by a gram-negative bacillus of the genus Brucella. It is endemic in Saudi Arabia [1], and considered to be a major health problem in this country [2,3]. Human brucellosis can either be acute or chronic, and presents with a variety of manifestations. The majority of patients present with pyrexia and musculoskeletal involvement [1][2][3][4]. This disease may also be complicated by the involvement of various systems in the body including cardiovascular, central nervous and genitourinary systems [5,6].Pulmonary brucellosis, on the other hand, is a rare complication [5,7]. A number of cases were reported in 1983 in a study of a spectrum of pneumonia found in Riyadh [8] indicating no details on the clinical picture or response to therapy. Brucellar pulmonary involvement has been reported in Kuwait [7,9,10]. We report a case of brucellar pneumonia with positive sputum culture. To the best of our knowledge, this is the first case to be reported from the Middle East with positive sputum for brucellosis. Case ReportA 75-year-old retired Saudi male was admitted with a two-week history of cough, productive of yellowish sputum and difficulty in breathing. The patient was known to have had chronic obstructive pulmonary disease (COPD) for ten years and hypertension of one year's duration. The patient has been a chronic smoker for more than 30 years. He used to go to the Outpatient Department (OPD) for follow-up for his chest problem. A few months prior to admission he experienced shortness of breath on exertion. This illness was preceded by rhinorrhea of one day's duration when he started to have fever, productive cough and shortness of breath at rest. The patient presented with no history of raw milk ingestion or contact with domestic animals. Examination revealed a patient in moderate respiratory distress but not cyanotic. His temperature was 37.5°C, pulse was 112/min and regular, respiratory rate was 40/min and his blood pressure was 140/90 Torr. The neck was supple with no cervical lymphadenopathy and no lymph node enlargement was noted. Respiratory system examination revealed a symmetrical movement of the chest with intercostal retractions and increased anteroposterior diameter; tactile vocal fremitus was increased in the right infra-axillary area; breath sounds were vesicular with scattered rhonchi and crepitations which were more prominent and coarser at the right base. Cardiovascular system examination was normal apart from tachycardia. Abdominal examination showed no organomegaly. Musculoskeletal system showed no peripheral or axial skeletal involvement.Investigations revealed WBC-9.6 × 10 9 /L, Hb -12.7 gm/dl, platelet -443 × 10 9 /L, Na+ -120 mmol/L and K+ -4.1 mmol/L. His chest radiograph revealed a peripheral infiltrate at the right lower zone with bilateral lung hyperinflation (Figure 1). The blood culture was sterile following seven days of incubation, while the sputum cult...

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Ceftriaxone in the Treatment of Acute and Subacute Human Brucellosis

Cited by 22 publications

References 10 publications

Systematic Review and Meta-Analysis of Randomized Clinical Trials in the Treatment of Human Brucellosis

Systematic Review and Meta-Analysis of Randomized Clinical Trials in the Treatment of Human Brucellosis

Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region

Brucella Pneumonia: A Case Report

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