A systematic review and meta-analysis of comparative clinical studies on antibiotic treatment of brucellosis.
Antibiotics
Brucellosis
Relapse
Systematic review
Treatment
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
16 Aug 2024
16 Aug 2024
Historique:
received:
14
05
2024
accepted:
07
08
2024
medline:
17
8
2024
pubmed:
17
8
2024
entrez:
16
8
2024
Statut:
epublish
Résumé
Brucellosis is a difficult to treat infection that requires antibiotic combinations administered over several weeks for clearance of infection and relapse prevention. This systematic review summarizes current evidence for antibiotic treatment of human brucellosis. PubMed, EMBASE, Scopus, CINAHL, Web of Science, and China Academic Journal databases were searched for prospective studies that had compared different antibiotic regimens for treating human brucellosis in the last 25 years. Thirty-four studies recruiting 4182 participants were eligible. Standard dual therapy with doxycycline + rifampicin had a higher risk of treatment failure compared to triple therapy which added streptomycin (RR: 1.98, 95% CI 1.17-3.35, p = 0.01) or levofloxacin (RR: 2.98, 95% CI 1.67-5.32, p = 0.0002), but a similar or lower risk compared to alternative dual antibiotic combinations (p > 0.05). The same combination had a higher risk of relapses compared to triple therapy which added streptomycin (RR: 22.12, 95% CI 3.48-140.52, p = 0.001), or levofloxacin (RR: 4.61, 95% CI 2.20-9.66, p < 0.0001), but a similar or lower risk compared to other dual antibiotic combinations (p > 0.05). Triple antibiotic therapy is more effective than standard dual therapy with rifampicin and doxycycline. However, the latter is also efficacious and suitable for uncomplicated disease.
Identifiants
pubmed: 39152180
doi: 10.1038/s41598-024-69669-w
pii: 10.1038/s41598-024-69669-w
doi:
Substances chimiques
Anti-Bacterial Agents
0
Doxycycline
N12000U13O
Rifampin
VJT6J7R4TR
Streptomycin
Y45QSO73OB
Levofloxacin
6GNT3Y5LMF
Types de publication
Journal Article
Systematic Review
Meta-Analysis
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
19037Informations de copyright
© 2024. The Author(s).
Références
Pappas, G., Akritidis, N., Bosilkovski, M. & Tsianos, E. Brucellosis. N. Engl. J. Med. 352, 2325–2336. https://doi.org/10.1056/NEJMra050570 (2005).
doi: 10.1056/NEJMra050570
pubmed: 15930423
Hördt, A. et al. Analysis of 1000+ type-strain genomes substantially improves taxonomic classification of alphaproteobacteria. Front. Microbiol. 11, 468. https://doi.org/10.3389/fmicb.2020.00468 (2020).
doi: 10.3389/fmicb.2020.00468
pubmed: 32373076
pmcid: 7179689
Holzer, K., Hoelzle, L. E. & Wareth, G. Genetic comparison of Brucella spp. and Ochrobactrum spp. erroneously included into the genus Brucella confirms separate genera. Ger. J. Vet. Res. 3, 31–37 (2023).
doi: 10.51585/gjvr.2023.1.0050
Jennings, G. J. et al. Brucellosis as a cause of acute febrile illness in Egypt. Trans. R. Soc. Trop. Med. Hyg. 101, 707–713. https://doi.org/10.1016/j.trstmh.2007.02.027 (2007).
doi: 10.1016/j.trstmh.2007.02.027
pubmed: 17442354
Laine, C. G., Johnson, V. E., Scott, H. M. & Arenas-Gamboa, A. M. Global estimate of human brucellosis incidence. Emerg. Infect. Dis. 29, 1789–1797. https://doi.org/10.3201/eid2909.230052 (2023).
doi: 10.3201/eid2909.230052
pubmed: 37610167
pmcid: 10461652
Khoshnood, S. et al. Prevalence, diagnosis, and manifestations of brucellosis: A systematic review and meta-analysis. Front. Vet. Sci. 9, 976215. https://doi.org/10.3389/fvets.2022.976215 (2022).
doi: 10.3389/fvets.2022.976215
pubmed: 36619963
pmcid: 9813401
Vigeant, P., Mendelson, J. & Miller, M. A. Human to human transmission of Brucella melitensis. Can. J. Infect. Dis. 6, 153–155. https://doi.org/10.1155/1995/909404 (1995).
doi: 10.1155/1995/909404
pubmed: 22514390
pmcid: 3327908
Dean, A. S., Crump, L., Greter, H., Schelling, E. & Zinsstag, J. Global burden of human brucellosis: A systematic review of disease frequency. PLoS. Negl. Trop. Dis. 6, e1865. https://doi.org/10.1371/journal.pntd.0001865 (2012).
doi: 10.1371/journal.pntd.0001865
pubmed: 23145195
pmcid: 3493380
Mor, S. et al. Pigs, pooches and pasteurisation: The changing face of brucellosis in Australia. Aust. J. Gen. Pract. 47, 99–103 (2018).
doi: 10.31128/AFP-08-17-4289
pubmed: 29621840
Solera, J. Update on brucellosis: Therapeutic challenges. Int. J. Antimicrob. Agents 36, S18–S20. https://doi.org/10.1016/j.ijantimicag.2010.06.015 (2010).
doi: 10.1016/j.ijantimicag.2010.06.015
pubmed: 20692127
Ariza, J. et al. Characteristics of and risk factors for relapse of brucellosis in humans. Clin. Infect. Dis. 20, 1241–1249. https://doi.org/10.1093/clinids/20.5.1241 (1995).
doi: 10.1093/clinids/20.5.1241
pubmed: 7620005
Ariza, J. et al. Perspectives for the treatment of brucellosis in the 21st century: The Ioannina recommendations. PLOS Med. 4, e317. https://doi.org/10.1371/journal.pmed.0040317 (2007).
doi: 10.1371/journal.pmed.0040317
pubmed: 18162038
pmcid: 2222927
Solís García del Pozo, J. & Solera, J. Systematic review and meta-analysis of randomized clinical trials in the treatment of human brucellosis. PLoS One 7, e32090. https://doi.org/10.1371/journal.pone.0032090 (2012).
doi: 10.1371/journal.pone.0032090
pubmed: 22393379
pmcid: 3290537
Alavi, S. M. & Alavi, L. Treatment of brucellosis: A systematic review of studies in recent twenty years. Caspian J. Intern. Med. 4, 636–641 (2013).
pubmed: 24009951
pmcid: 3755828
Huang, S. et al. Better efficacy of triple antibiotics therapy for human brucellosis: A systematic review and meta-analysis. PLoS. Negl. Trop. Dis. 17, e0011590. https://doi.org/10.1371/journal.pntd.0011590 (2023).
doi: 10.1371/journal.pntd.0011590
pubmed: 37708094
pmcid: 10501551
Higgins, J. P. T., Thompson, S. G., Deeks, J. J. & Altman, D. G. Measuring inconsistency in meta-analysis. BMJ 327, 557–560 (2003).
doi: 10.1136/bmj.327.7414.557
pubmed: 12958120
pmcid: 192859
Review Manager [Computer program] v. 5.1 (The Cochrane Collaboration, Copenhagen, 2011).
Granholm, A., Alhazzani, W. & Møller, M. H. Use of the GRADE approach in systematic reviews and guidelines. Br. J. Anaesth. 123, 554–559. https://doi.org/10.1016/j.bja.2019.08.015 (2019).
doi: 10.1016/j.bja.2019.08.015
pubmed: 31558313
Agalar, C., Usubutun, S. & Turkyilmaz, R. Ciprofloxacin and rifampicin versus doxycycline and rifampicin in the treatment of brucellosis. Eur. J. Clin. Microbiol. Infect. Dis. 18, 535–538. https://doi.org/10.1007/s100960050344 (1999).
doi: 10.1007/s100960050344
pubmed: 10517189
Alavi, S. M. & Rajabzadeh, A. R. Comparison of two chemotherapy regimen: Doxycycline-rifampicin and doxycycline cotrimoxazol in the brucellosis patients Ahvaz, Iran, 2004–2006. Pak. J. Med. Sci. 23, 889–892 (2007).
Alikhani, A. & Heidarzadeh, A. A new therapeutic management in acute uncomplicated brucellosis: Comparison between three month-ofloxacin and doxycycline-based regimens. J. Isfahan Med. Sch. 25, 55–60 (2007).
Alp, E. et al. Doxycycline plus streptomycin versus ciprofloxacin plus rifampicin in spinal brucellosis [ISRCTN31053647]. BMC Infect. Dis. https://doi.org/10.1186/1471-2334-6-72 (2006).
doi: 10.1186/1471-2334-6-72
pubmed: 16606473
pmcid: 1458347
Bayindir, Y., Sonmez, E., Aladag, A. & Buyukberber, N. Comparison of five antimicrobial regimens for the treatment of brucellar spondylitis: A prospective, randomized study. J. Chemother. 15, 466–471. https://doi.org/10.1179/joc.2003.15.5.466 (2003).
doi: 10.1179/joc.2003.15.5.466
pubmed: 14598939
Didgar, F., Sarmadian, H., Zarin Far, N., Rafiee, M. & Choghae, M. Comparison between efficacy of ciprofioxacin-doxycycline and rifampin-doxycycline regimens in treatment of brucellosis. J. Zanjan Univ. Med. Sci. Health Serv. 20, 2 (2012).
El Miedany, Y. M., El Gaafary, M., Baddour, M. & Ahmed, I. Human brucellosis: Do we need to revise our therapeutic policy?. J. Rheumatol. 30, 2666–2672 (2003).
pubmed: 14719211
Ersoy, Y., Sonmez, E., Tevfik, M. R. & But, A. D. Comparison of three different combination therapies in the treatment of human brucellosis. Trop. Doct. 35, 210–212. https://doi.org/10.1258/004947505774938765 (2005).
doi: 10.1258/004947505774938765
pubmed: 16354469
Hasanain, A., Mahdy, R., Mohamed, A. & Ali, M. A randomized, comparative study of dual therapy (doxycycline-rifampin) versus triple therapy (doxycycline-rifampin-levofloxacin) for treating acute/subacute brucellosis. Braz. J. Infect. Dis. 20, 250–254. https://doi.org/10.1016/j.bjid.2016.02.004 (2016).
doi: 10.1016/j.bjid.2016.02.004
pubmed: 27086734
pmcid: 9425512
Hasanjani Roushan, M. R., Mohraz, M., Hajiahmadi, M., Ramzani, A. & Valayati, A. A. Efficacy of gentamicin plus doxycycline versus streptomycin plus doxycycline in the treatment of brucellosis in humans. Clin. Infect. Dis. 42, 1075–1080. https://doi.org/10.1086/501359 (2006).
doi: 10.1086/501359
pubmed: 16575723
Hashemi, S. H. et al. Comparison of doxycycline-streptomycin, doxycycline-rifampin, and ofloxacin-rifampin in the treatment of brucellosis: A randomized clinical trial. Int. J. Infect. Dis. 16, e247-251. https://doi.org/10.1016/j.ijid.2011.12.003 (2012).
doi: 10.1016/j.ijid.2011.12.003
pubmed: 22296864
Karabay, O., Sencan, I., Kayas, D. & Sahin, I. Ofloxacin plus rifampicin versus doxycycline plus rifampicin in the treatment of brucellosis: A randomized clinical trial [ISRCTN11871179]. BMC Infect. Dis. 4, 18. https://doi.org/10.1186/1471-2334-4-18 (2004).
doi: 10.1186/1471-2334-4-18
pubmed: 15214959
pmcid: 459220
Karami, A., Mobaien, A., Jozpanahi, M., Moghtader-Mojdehi, A. & Javaheri, M. Effect of 8-week and 12-week triple therapy (doxycycline, rifampicin, and gentamicin) on brucellosis: A comparative study. J. Acute Dis. 9, 161–165. https://doi.org/10.4103/2221-6189.288594 (2020).
doi: 10.4103/2221-6189.288594
Keramat, F., Ranjbar, M., Mamani, M., Hashemi, S. H. & Zeraati, F. A comparative trial of three therapeutic regimens: ciprofloxacin-rifampin, ciprofloxacin-doxycycline and doxycycline-rifampin in the treatment of brucellosis. Trop. Doct. 39, 207–210. https://doi.org/10.1258/td.2009.090030 (2009).
doi: 10.1258/td.2009.090030
pubmed: 19762571
Majzoobi, M. M., Hashmi, S. H., Emami, K. & Soltanian, A. R. Combination of doxycycline, streptomycin and hydroxychloroquine for short-course treatment of brucellosis: A single-blind randomized clinical trial. Infection 50, 1267–1271. https://doi.org/10.1007/s15010-022-01806-x (2022).
doi: 10.1007/s15010-022-01806-x
pubmed: 35353333
pmcid: 8966606
Mile, B. et al. Doxycycline-rifampin versus doxycycline-rifampin-gentamicin in treatment of human brucellosis. Trop. Doct. 42, 13–17. https://doi.org/10.1258/td.2011.110284 (2012).
doi: 10.1258/td.2011.110284
pubmed: 22290107
Ranjbar, M. et al. Comparison between doxycycline-rifampin-amikacin and doxycycline-rifampin regimens in the treatment of brucellosis. Int. J. Infect. Dis. 11, 152–156. https://doi.org/10.1016/j.ijid.2005.11.007 (2007).
doi: 10.1016/j.ijid.2005.11.007
pubmed: 16798042
Roushan, M. R. et al. Comparison of the efficacy of gentamicin for 5 days plus doxycycline for 8 weeks versus streptomycin for 2 weeks plus doxycycline for 45 days in the treatment of human brucellosis: A randomized clinical trial. J. Antimicrob. Chemother. 65, 1028–1035. https://doi.org/10.1093/jac/dkq064 (2010).
doi: 10.1093/jac/dkq064
pubmed: 20215128
Roushan, M. R., Gangi, S. M. & Ahmadi, S. A. Comparison of the efficacy of two months of treatment with co-trimoxazole plus doxycycline vs. co-trimoxazole plus rifampin in brucellosis. Swiss Med. Wkly. 134, 564–568. https://doi.org/10.4414/smw.2004.10665 (2004).
doi: 10.4414/smw.2004.10665
pubmed: 15551160
Solera, J. et al. A randomized, double-blind study to assess the optimal duration of doxycycline treatment for human brucellosis. Clin. Infect. Dis. 39, 1776–1782. https://doi.org/10.1086/426024 (2004).
doi: 10.1086/426024
pubmed: 15578399
Taghvaee, M. R. E., Nozadi, M. S. & Hassani, M. A comparison between doxycycline-rifampin and ciprofloxacin-rifampin regimens in the treatment of acute brucellosis. Indian J. Med. Sci. 65, 436–443. https://doi.org/10.4103/0019-5359.109263 (2011).
doi: 10.4103/0019-5359.109263
pubmed: 23511044
Saltoglu, N., Tasova, Y., Inal, A. S., Seki, T. & Aksu, H. S. Efficacy of rifampicin plus doxycycline versus rifampicin plus quinolone in the treatment of brucellosis. Saudi Med. J. 23, 921–924 (2002).
pubmed: 12235463
Salehi, M. et al. Comparing efficacy and safety of high-dose and standard-dose rifampicin in the treatment of brucellosis: A randomized clinical trial. J. Antimicrob. Chemother. 78, 1084–1091. https://doi.org/10.1093/jac/dkad051 (2023).
doi: 10.1093/jac/dkad051
pubmed: 36880215
Sofian, M. et al. Comparison of two durations of triple-drug therapy in patients with uncomplicated brucellosis: A randomized controlled trial. Scand. J. Infect. Dis. 46, 573–577. https://doi.org/10.3109/00365548.2014.918275 (2014).
doi: 10.3109/00365548.2014.918275
pubmed: 24934986
Yin, M. et al. Comparison of different antibiotic combination therapies for brucellosis. Chin. J. Exp. Clin. Infect. Dis. (Electron. Ed.) 9, 81–83 (2015).
Sun, L. Effects of triple therapy of ofloxacin, rifampicin and doxycycline in treatment of patients with brucellosis. Chin. People’s Health 32, 20–21 (2020).
Zhang, C., Wang, Z., Yang, Y. J. & Li, Y. Efficacy of rifampicin combined with doxycycline and levofloxacin in the treatment of brucellosis. Med. Inf. 35, 112–114 (2022).
Jiang, L. Comparison of the efficacy of different antibacterial drug combination regimens in the treatment of brucellosis. Chin. J. Clini. Ration. Drug Use 13, 53–54 (2020).
Liang, C. & Li, J. The influence of different antibiotic combination regimens on the treatment effect, recurrence rate, and incidence of adverse reactions in brucellosis. Strait Pharm. J. 30, 221–222 (2018).
Feng, Z. & Ma, J. Study on the clinical application value of doxycycline combined with rifampicin in the treatment of chronic brucella arthritis and its effect on pain. Clin. Med. Res. Pract. 1, 65–66 (2016).
Sha, R. Comparison of different combination therapy regimens of antimicrobial drugs for brucellosis. World Latest Med. Inf. 17, 127–128 (2017).
Liu, F. & Du, N. Efficacy observation of levofloxacin combined with doxycycline in the treatment of brucellosis. Heilongjiang Med. Sci. 44, 86–87 (2021).
Liu, J., Liu, A. J. & Mu, W. D. Efficacy of doxycycline combined with compound sulfamethoxazole in the treatment of acute phase brucellosis. Lab. Med. Clin. 16, 3376–3378 (2019).
Liu, D. Clinical efficacy observation of rifampicin combined with doxycycline in the treatment of acute brucellosis. Pract. Med. China 13, 77–79 (2018).
Wareth, G. et al. The perspective of antibiotic therapeutic challenges of brucellosis in the Middle East and North African countries: Current situation and therapeutic management. Transbound. Emerg. Dis. 69, e1253–e1268. https://doi.org/10.1111/tbed.14502 (2022).
doi: 10.1111/tbed.14502
pubmed: 35244335
Trott, D. J., Abraham, S. & Adler, B. Antimicrobial resistance in Leptospira, Brucella, and other rarely investigated veterinary and zoonotic pathogens. Microbiol. Spectr. https://doi.org/10.1128/microbiolspec.ARBA-0029-2017 (2018).
doi: 10.1128/microbiolspec.ARBA-0029-2017
pubmed: 30027885
Abdel-Maksoud, M. et al. In vitro antibiotic susceptibility testing of Brucella isolates from Egypt between 1999 and 2007 and evidence of probable rifampin resistance. Ann. Clin. Microbiol. Antimicrob. 11, 24. https://doi.org/10.1186/1476-0711-11-24 (2012).
doi: 10.1186/1476-0711-11-24
pubmed: 22929054
pmcid: 3464789
Mollalo, A., Alimohammadi, A. & Khoshabi, M. Spatial and spatio-temporal analysis of human brucellosis in Iran. Trans. R. Soc. Trop. Med. Hyg. 108, 721–728. https://doi.org/10.1093/trstmh/tru133 (2014).
doi: 10.1093/trstmh/tru133
pubmed: 25157126
Khalilian, M.-S., Ramazanpour, J., Hosseini, S. M., Narrei, S. & Zeinalian, M. Trends of human brucellosis in Central Iran (2010–2018). J. Res. Med. Sci. 26, 55 (2021).
doi: 10.4103/jrms.JRMS_621_20
pubmed: 34729063
pmcid: 8506245