A New Therapeutic Management in Acute Uncomplicated Brucellosis: Comparison between Three Month- Ofloxacin and Doxycycline- based Regimens

BACKGROUND:
Human brucellosis is a common bacterial zoonosis in I.R.of Iran, and with current therapy has significant relapse rate and side effects. However, the optimal duration of therapy has not been determined and side effects cause poor compliance. This study focused on comparison between effects and complications of two therapeutic regimens.

METHODS:
In this single-blind randomized trial, 78 uncomplicated brucellosis patients were recruited and allocated into two tails of study by fixed block allocation method. Patients of doxycycline tail were treated with streptomycin, doxycyline plus rifampin (streptomycin plus doxycycline for first month; and, doxycycline plus rifampin for second and third months). Patients of ofloxacin tail were treated with streptomycin, ofloxacin plus rifampin (streptomycin plus ofloxacin for first month and ofloxacin plus rifampin for second and third months) for three months.
Therapeutic outcome was evaluated by measuring efficacy, relapse rate and drugs' GI and skin side -effects. Active brucellosis diagnosed by serology (Wright and 2 ME tests) at the start, 3 and 6 month after drug therapy. The data were analyzed by stata 8.0 soft ware. The proportions were compared by fisher exact test. Significance level was 0.05. The results were reports as proportion (standard error).


FINDINGS:
At the end of the study, the curative results were similar in doxycycline and ofloxacin tail (100%). The complication rate had Significant difference in doxycycline and ofloxacin tails, 48.6±8.3% versus 13.2±5.5%, respectively (p<0.001, fisher exact test). The recurrence rate in both groups during six month follow up after complete treatment process was zero.

CONCLUSION:
It seems that duration is more important factor in the management of the brucellosis. Treatment of acute uncomplicated brucellosis in human for three month had no relapse and decreased side effects with ofloxacin included regimen.

KEY WORDS:
Brucellosis, ofloxacin, doxycycline