Brucellosis medical therapy

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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

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][2]

Medical Therapy

  • Treatment can be effective with antibiotics.
  • 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.
  • Mortality is low (<2%), and is usually associated with endocarditis.[3][1]

Antimicrobial Regimen

  • 1.Uncomplicated brucellosis in adults and children ≥8yrs of age
  • 2. Complications of brucellosis
  • 2.1 Spondylitis
  • 2.2 Neurobrucellosis
  • 2.3 Brucella endocarditis
  • 3. Pregnancy
  • 4.For children < 8 yrs of age
  • 5.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. 1.0 1.1 Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 1, 2016
  2. Brucellosis. CDC. http://www.cdc.gov/brucellosis/treatment/index.html. Accessed on February 5, 2016
  3. Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 1, 2016
  4. Corbel, Michael (2006). Brucellosis in humans and animals. Geneva: World Health Organization. ISBN 9241547138.
  5. Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
  6. Brucellosis. CDC. http://www.cdc.gov/brucellosis/veterinarians/rb51-reduce-risk.html. Accessed on February 5, 2016

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