Efficacy of rifampicin plus doxycycline versus rifampicin plus quinolone in the treatment of brucellosis

OBJECTIVE: The aim of this study was to compare the efficacy, tolerability and side effects of 2 treatment regimens for brucellosis.

METHODS: Fifty-seven patients with brucellosis were followed up in our clinic. The patients were given rifampicin plus doxycycline or rifampicin plus quinolone. Thirty patients (group one) received rifampicin 600mg/daily plus doxycycline 100mg twice daily and 27 patients (group 2) received quinolones (ofloxacin 200mg twice daily peroral) plus rifampicin 600mg/daily. Both regimens were administered for 45-days. During the course of treatment, patients were followed for the disappearance of physical signs and symptoms. All patients were followed up at least 6-months after cessation of therapy. Diagnosis of brucellosis was established by utilizing the following criteria; Isolation of brucella species in blood, body fluids (Sceptor, Becton-Dickinson, United States of America), compatible clinical picture supported by the detection of specific antibodies at significant titers or demonstration, or both, of an at least 4 fold rise in antibody titer in serum specimens taken after 2-weeks. Significant titer was determined to be >one/160 in the standart tube agglutination test (Brucella abortus Cromatest, Linear Chemicals, Spain).

RESULTS: Of patients 14 (24.5%) were male and 43 (75.5%) were female. Mean age was 36.8 ± 11.3 years (range 15-65). Sacroiliitis was the most common involvement in both groups 9 (30%) versus 6 (22%), followed by peripheral arthritis 6 (20%) versus 6 (22%). In this study, relapse rate was found 7.2% and 6.7% for ofloxacin plus rifampicin and doxycycline plus rifampicin for a 6-week therapy (p>0.05). No significant adverse effects were associated with either combination.

CONCLUSION: These results indicated that a 45-day course of doxycycline plus ofloxacin combination was as effective as the doxycycline plus rifampicin combination in patients with brucellosis.