Comparison between doxycycline–rifampin–amikacin and doxycycline–rifampin regimens in the treatment of brucellosis

Abstract

Given the fact that the ADR regimen had a higher efficacy and more rapid action in terms of relief of symptoms compared to the DR regimen, and that no significant difference in drug side-effects and disease relapse existed in the patients of either group, adding amikacin to the DR standard treatment regimen seems beneficial.

Human Brucellosis in Macedonia – 10 Years of Clinical Experience in Endemic Region

“…The selection of antimicrobial agents depends on the clinical presentation, age of the patient, pregnancy, drug side effects, and co-morbidity; in addition, in regions with scarce resources, therapeutic decisions are also determined by treatment costs and drug availability. The triple antimicrobial combination is rarely implemented and its use is traditionally restricted to patients with neurobrucellosis, endocarditis, or abscesses (3,23,63,64). Nevertheless, the highest cure rate can be achieved with a triple therapy (3) and adding a third drug to the standard regimen seems to be beneficial (63).…”

“…The triple antimicrobial combination is rarely implemented and its use is traditionally restricted to patients with neurobrucellosis, endocarditis, or abscesses (3,23,63,64). Nevertheless, the highest cure rate can be achieved with a triple therapy (3) and adding a third drug to the standard regimen seems to be beneficial (63). In two reports, children treated with three drugs had a better outcome than those treated with two drugs (65,66).…”

Brucellosis with Bone Marrow Granulomas- Two Case Reports

“…Different antibiotic regimens have been employed in the treatment of brucellosis including the following in various combinations: TMP/SMZ, rifampicin, doxycycline, ciprofloxacin, gentamicin and streptomycin. The mean duration of treatment is usually 6 weeks, but in case of complications like infective endocarditis or spinal involvement, therapy may be prolonged for up to 3 months [13][14][15][16][17] .…”

A comparison between doxycycline-rifampin and ciprofloxacin-rifampin regimens in the treatment of acute Brucellosis

“…A similar result was reported previously. [21][22][23][24][25][26][27][28][29] Some researchers, such as Bosilkovski, et al, have reported some other factors such as chronicity of the infection and its localization which have played pivotal roles in the failure rate. This is a problem that can be circumvented by lengthening the period of therapy and adding another anti-brucellosis agent to the regimen.…”

“…[22] Akova, et al, had such a priority due to lower gastrointestinal side-effects. [23] However, this could not be a definite cause for their priority, because training patients on how they consume doxycycline properly and drinking at least a cup of water after taking the drug, in an upright position, could prevent the side-effect of esophagitis.…”