Brucellosis medical therapy

Jump to navigation Jump to search

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

X-Ray

CT Scan

MRI

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Brucellosis medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Brucellosis medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Brucellosis medical therapy

CDC on Brucellosis medical therapy

Brucellosis medical therapy in the news

Blogs on Brucellosis medical therapy

Directions to Hospitals Treating Brucellosis

Risk calculators and risk factors for Brucellosis medical therapy

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

Medical Therapy

Treatment can be difficult. Doctors can prescribe effective antibiotics. Usually, doxycycline and rifampin are used in combination for 6 weeks to prevent reoccuring 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. Mortality is low (<2%), and is usually associated with endocarditis [1].

Acute Pharmacotherapy

The gold standard treatment for adults is daily intramuscular injections of streptomycin 1 g for 14 days and oral doxycycline 100 mg twice daily for 45 days (concurrently). Gentamicin 5 mg/kg by intramuscular injection once daily for 7 days is an acceptable substitute when streptomycin is not available or difficult to obtain.[2] Another widely used regimen is doxycycline plus rifampin twice daily for at least 6 weeks. This regimen has the advantage of oral administration. A triple therapy of doxycycline, together with rifampin and cotrimoxazole has been used succefully to treat neurobrucellosis. [3] Doxycycline is able to cross the blood-brain barrier, but requires the addition of two other drugs to prevent relapse. Ciprofloxacin and co-trimoxazole therapy is associated with an unacceptably high rate of relapse.

In brucellic endocarditis surgery is required for an optimal outcome.

Even with optimal antibrucellic therapy relapses still occur in 5-10 percent of patients with Malta fever. Experiments have shown that cotrimoxyzol and rifampin are both safe drugs to use in treatment of pregnant women who have Brucellosis.

Reference

  1. http://www.cdc.gov/ncidod/dbmd/diseaseinfo
  2. Roushan MRH, Mohraz M, Hajiahmadi M, Ramzani A, Valayati AA (2006). "Efficacy of gentamicin plus doxycycline versus streptomycin plus doxycycline in the treatment of brucellosis in humans". Clin Infect Dis. 42 (8): 1075&ndash, 80.
  3. McLean DR, Russell N, Khan MY (1992). "Neurobrucellosis: Clinical and therapeutic features". Clin Infect Dis. 15: 582&ndash, 90.

Template:WH Template:WS