BACKGROUND: Traditional regimens for the treatment of brucellosis are associated with significant relapse rates. The aim of this study was to compare the efficacy of ofloxacin plus rifampin (OFX-RIF) versus doxycycline plus streptomycin (DOX-STR) and doxycycline plus rifampin (DOX-RIF) regimens in the treatment of brucellosis. METHODS:Two hundred and nineteen patients with brucellosis were enrolled in a randomized clinical trial; 28 cases were withdrawn because they did not attend the follow-up. Out of 191 patients with brucellosis, 64 received OFX-RIF, 62 receivedDOX-RIF, and 65 patients received DOX-STR regimens. All patients were assessed during the period of therapy in the second, fourth, and sixth weeks by clinical course and were also followed up clinically and serologically for 6 months after the cessation of therapy. RESULTS: The highest clinical response (95.4%) was observed in the DOX-STR group (p=0.009). The results of multivariate analysis indicate that treatment with DOX-STR had the least therapeutic failures among the three groups (p=0.033). Adverse reactions were seen in 16.8% of patients, but there was no significant difference among the three groups (p=0.613). The lowest relapse rate (4.6%) was observed in the DOX-STR group (p=0.109). CONCLUSIONS: We conclude that the DOX-STR combination should remain the first-line regimen for the treatment of brucellosis in our region; we recommend DOX-RIF and OFX-RIF combinations as the second-line regimens. Copyright Â
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BACKGROUND: Traditional regimens for the treatment of brucellosis are associated with significant relapse rates. The aim of this study was to compare the efficacy of ofloxacin plus rifampin (OFX-RIF) versus doxycycline plus streptomycin (DOX-STR) and doxycycline plus rifampin (DOX-RIF) regimens in the treatment of brucellosis. METHODS: Two hundred and nineteen patients with brucellosis were enrolled in a randomized clinical trial; 28 cases were withdrawn because they did not attend the follow-up. Out of 191 patients with brucellosis, 64 received OFX-RIF, 62 received DOX-RIF, and 65 patients received DOX-STR regimens. All patients were assessed during the period of therapy in the second, fourth, and sixth weeks by clinical course and were also followed up clinically and serologically for 6 months after the cessation of therapy. RESULTS: The highest clinical response (95.4%) was observed in the DOX-STR group (p=0.009). The results of multivariate analysis indicate that treatment with DOX-STR had the least therapeutic failures among the three groups (p=0.033). Adverse reactions were seen in 16.8% of patients, but there was no significant difference among the three groups (p=0.613). The lowest relapse rate (4.6%) was observed in the DOX-STR group (p=0.109). CONCLUSIONS: We conclude that the DOX-STR combination should remain the first-line regimen for the treatment of brucellosis in our region; we recommend DOX-RIF and OFX-RIF combinations as the second-line regimens. Copyright Â
Authors: D Ozturk-Engin; H Erdem; S Gencer; S Kaya; A I Baran; A Batirel; R Tekin; M K Celen; A Denk; S Guler; M Ulug; H Turan; A U Pekok; G Mermut; S Kaya; M Tasbakan; N Tulek; Y Cag; A Inan; A Yalci; C Ataman-Hatipoglu; I Gonen; A Dogan-Celik; F Bozkurt; S Gulsun; M Sunnetcioglu; T Guven; F Duygu; E Parlak; H Sozen; S Tosun; T Demirdal; E Guclu; O Karabay; N Uzun; O Gunal; H Diktas; A Haykir-Solay; A Erbay; C Kader; O Aydin; A Erdem; N Elaldi; A Kadanali; Z Yulugkural; L Gorenek; M Altındis; S Bolukcu; C Agalar; N Ormeci Journal: Eur J Clin Microbiol Infect Dis Date: 2014-02-21 Impact factor: 3.267