Failure of Short Term Antimicrobial Therapy in Childhood Brucellosis

A multicenter retrospective study of childhood brucellosis in Chicago, Illinois from 1986 to 2008

“…42,43 The optimal duration of therapy remains unclear, though treatment of less than 45 days may be associated with higher relapse rates. 42,[44][45][46] Our study had a relapse rate of 19%, which is similar to that of other recent reported relapse rates in children of 0-25%. 6,31,[34][35][36][37][38] Early antibiotic regimens utilizing single drug therapy have been found to be less efficacious than the current recommendations of combination therapy involving two or more medications active against Brucella.…”

Diagnostic and Therapeutic Challenges of Childhood Brucellosis in a Nonendemic Country

“…32 These findings have not been replicated, and others have called for a minimum of 6 weeks of therapy. 13,33,34 Some have proposed even longer durations of therapy in adults. 35 Average relapse rates of brucellosis are ϳ10%.…”

Comparison of various treatments in childhood brucellosis

“…On the other hand, Al-Eissa et al [7] compared different combinations of TMP-SMZ or tetracyclines with streptomycin or rifampin in a sample of 102 cases and found that 3-week regimens presented an unacceptable relapse rate (85%); therefore, they recommended that treatment must be prolonged to at least 6 weeks. In later studies, treatment with at least two antibiotics for not less than six weeks appear to be effective [6,21].…”

“…There were studies reporting success either with 5 days or with 1-2 weeks of gentamicin treatment. Thus, while shorter gentamicin treatment could provide the same benefit, longer treatment with more side effects may not be safe [4,6,21].…”