Efficacy and Tolerability of Antibiotic Combinations in Neurobrucellosis: Results of the Istanbul Study

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dc.contributor.authorErdem, Hakan
dc.contributor.authorUlu-Kilic, Aysegul
dc.contributor.authorKilic, Selim
dc.contributor.authorKarahocagil, Mustafa
dc.contributor.authorShehata, Ghaydaa
dc.contributor.authorEren-Tulek, Necla
dc.contributor.authorYetkin, Funda
dc.date.accessioned2024-04-24T17:11:52Z
dc.date.available2024-04-24T17:11:52Z
dc.date.issued2012
dc.departmentDicle Üniversitesien_US
dc.description.abstractNo data on whether brucellar meningitis or meningoencephalitis can be treated with oral antibiotics or whether an intravenous extended-spectrum cephalosporin, namely, ceftriaxone, which does not accumulate in phagocytes, should be added to the regimen exist in the literature. The aim of a study conducted in Istanbul, Turkey, was to compare the efficacy and tolerability of ceftriaxone-based antibiotic treatment regimens with those of an oral treatment protocol in patients with these conditions. This retrospective study enrolled 215 adult patients in 28 health care institutions from four different countries. The first protocol (P1) comprised ceftriaxone, rifampin, and doxycycline. The second protocol (P2) consisted of trimethoprim-sulfamethoxazole, rifampin, and doxycycline. In the third protocol (P3), the patients started with P1 and transferred to P2 when ceftriaxone was stopped. The treatment period was shorter with the regimens which included ceftriaxone (4.40 +/- 2.47 months in P1, 6.52 +/- 4.15 months in P2, and 5.18 +/- 2.27 months in P3) (P = 0.002). In seven patients, therapy was modified due to antibiotic side effects. When these cases were excluded, therapeutic failure did not differ significantly between ceftriaxone-based regimens (n = 5/166, 3.0%) and the oral therapy (n = 4/42, 9.5%) (P = 0.084). The efficacy of the ceftriaxone-based regimens was found to be better (n = 6/166 [3.6%] versus n = 6/42 [14.3%]; P = 0.017) when a composite negative outcome (CNO; relapse plus therapeutic failure) was considered. Accordingly, CNO was greatest in P2 (14.3%, n = 6/42) compared to P1 (2.6%, n = 3/ 117) and P3 (6.1%, n = 3/ 49) (P = 0.020). Seemingly, ceftriaxone-based regimens are more successful and require shorter therapy than the oral treatment protocol.en_US
dc.identifier.doi10.1128/AAC.05974-11
dc.identifier.endpage1528en_US
dc.identifier.issn0066-4804
dc.identifier.issn1098-6596
dc.identifier.issue3en_US
dc.identifier.pmid22155822
dc.identifier.startpage1523en_US
dc.identifier.urihttps://doi.org/10.1128/AAC.05974-11
dc.identifier.urihttps://hdl.handle.net/11468/17757
dc.identifier.volume56en_US
dc.identifier.wosWOS:000300623300049
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherAmer Soc Microbiologyen_US
dc.relation.ispartofAntimicrobial Agents and Chemotherapy
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subject[No Keyword]en_US
dc.titleEfficacy and Tolerability of Antibiotic Combinations in Neurobrucellosis: Results of the Istanbul Studyen_US
dc.titleEfficacy and Tolerability of Antibiotic Combinations in Neurobrucellosis: Results of the Istanbul Study
dc.typeArticleen_US

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