QUINOLONES IN TREATMENT OF HUMAN BRUCELLOSIS - COMPARATIVE TRIAL OF OFLOXACIN-RIFAMPIN VERSUS DOXYCYCLINE-RIFAMPIN

Quinolones have been reported to be active against Brucella species in vitro. In this prospective randomized study, the efficacy and safety of the combination of ofloxacin plus rifampin were compared with the e fficacy and safety of doxycycline plus rifampin, both combinations adm inistered for a 6-week period in treatment of brucellosis. Sixty-one p atients were enrolled in the study, and 49 had blood or bone marrow cu ltures positive for Brucella melitensis. Thirty patients received 200 mg of doxycycline plus 600 mg of rifampin once daily, and 31 patients were treated with 400 mg of ofloxacin plus 600 mg of rifampin once dai ly for 6 weeks. Nine patients in each group had complications of the d isease. There was one therapeutic failure in the ofloxacin-rifampin tr eatment group, and one patient from each group relapsed (3.3% of those in the doxycycline-rifampin treatment group versus 3.2% of those in t he ofloxacin-rifampin treatment group). Gastric discomfort was the maj or side effect observed in 13 patients (43.3%) who received doxycyclin e plus rifampin, whereas only 2 patients (6.5%) treated with ofloxacin plus rifampin complained of gastric irritation. These results suggest that the combination of ofloxacin plus rifampin administered for 6 we eks is as effective as doxycycline plus rifampin given for the same pe riod, regardless of the presence of complications of the disease.