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Two hundred and nineteen patients with brucellosis were enrolled in a randomized clinical trial; 28 cases were withdrawn because they did not attend the follow-up.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.