TREATMENT OF HUMAN BRUCELLOSIS WITH NETILMICIN AND DOXYCYCLINE

We conducted a prospective, noncomparative, multicenter study to asses s the safety and efficacy of doxycycline and netilmicin in the treatme nt of human brucellosis. The study included 64 patients who had acute brucellosis without endocarditis or neurobrucellosis. The treatment sc hedule consisted of the administration of 100 mg of doxycycline (or 5 mg/[kg . d] if body weight less than or equal to 40 kg) twice a day or ally for 45 days, plus 300 mg of netilmicin (6 mg/[kg . d] if body wei ght less than or equal to 50 kg) intramuscularly once daily for 7 days , Therapeutic failure was noted in 5 patients (7.7%; 95% confidence in terval [CI], 2.5%-17.1%), of whom 2 had spondylitis, 1 had sacroiliiti s, and 1 had a splenic abscess that required splenectomy, Relapse was noted in eight patients (12.5%; 95% CI, 5.6%-23.2%), When relapse was considered in combination with initial lack of efficacy, 13 patients ( 21.9%; 95% CI, 12.3%-33.9%) failed to respond to therapy. Fifteen pati ents (23%; 95% CI, 13.5%-35.2%) had adverse effects, and one patient ( 1.5%) had a treatment-limiting adverse effect, Combination therapy wit h netilmicin/doxycycline may be effective in treating acute brucellosi s. However, prospective controlled trials must confirm these results.