Brucellosis medical therapy: Difference between revisions

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Latest revision as of 20:44, 29 July 2020

Brucellosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Brucellosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Principles of diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

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Treatment

Medical Therapy

Primary Prevention

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Cost-Effectiveness of Therapy

Future or Investigational Therapies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Danitza Lukac Vishal Devarkonda, M.B.B.S[3]

Overview

The mainstay of therapy for brucellosis is antimicrobial therapy. The preferred regimen for uncomplicated brucellosis is a combination of Doxycycline and streptomycin. Rifampicin is the drug of choice for brucellosis in pregnancy. For children less than 8 years of age, the preferred regimen is either gentamycin or a combination of trimethoprim-sulfamethoxazole and streptomycin.[1]

Medical Therapy

The mainstay of therapy for brucellosis is antimicrobial therapy:[2][3][4][5][6][7]

  • Doxycycline and streptomycin are used in combination for 2-3 weeks to prevent recurring infection.
  • Depending on the timing of treatment and severity of illness, recovery may take a few weeks to several months.
  • The use of more than one antibiotic is needed for several weeks, due to the fact that the bacteria incubates within cells.
Antimicrobial therapy for Brucellosis
Uncomplicated brucellosis in adults and children ≥8yrs of age
Complications of brucellosis
  • Spondylitis
  • Neurobrucellosis
  • Brucella endocarditis
Pregnancy
.For children < 8 yrs of age
.Post-exposure prophylaxis
  • Preferred regimen (1): Doxycycline 100mg PO bid for at least 3 weeks
  • Preferred regimen (2): TMP/SMZ 160 mg/800mg PO bid for at least 3 weeks

Reference

  1. Brucellosis. CDC. http://www.cdc.gov/brucellosis/treatment/index.html. Accessed on February 5, 2016
  2. "CDC".
  3. Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 9th, 2017
  4. Young EJ (1995). "Brucellosis: current epidemiology, diagnosis, and management."Curr Clin Top Infect Dis15: 115–28. PMID 7546364
  5. Aygen B, Doganay M, Sumerkan B, et al. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Malad Infect 2002; 32:485.
  6. Herrick JA, Lederman RJ, Sullivan B, et al. Brucella arteritis: clinical manifestations, treatment, and prognosis. Lancet Infect Dis 2014; 14:520.
  7. Ariza J, Bosilkovski M, Cascio A, Colmenero JD, Corbel MJ, Falagas ME; et al. (2007). "Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations."PLoS Med4 (12): e317. 

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