Journal Article

A Randomized, Double-Blind Study to Assess the Optimal Duration of Doxycycline Treatment for Human Brucellosis

Javier Solera, Paloma Geijo, Jose Largo, Manuel Rodriguez-Zapata, Julio Gijón, Elisa Martinez-Alfaro, Elena Navarro and Miguel Angel Macia

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 39, issue 12, pages 1776-1782
Published in print December 2004 | ISSN: 1058-4838
Published online December 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/426024
A Randomized, Double-Blind Study to Assess the Optimal Duration of Doxycycline Treatment for Human Brucellosis

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Background. Human brucellosis is usually treated with a combination of tetracyclines and aminoglycosides. However, the optimal duration of therapy has not been clearly determined.

Methods. We conducted a prospective, double-blind, randomized, multicenter study comparing treatment with doxycycline (100 mg po b.i.d.) for 30 days (30-day group) with the same dosage of doxycycline for 45 days (45-day group) in patients with brucellosis without endocarditis, spondylitis, or neurobrucellosis. All patients were treated with gentamicin (240 mg im once daily) for the first 7 days. Therapeutic outcome was evaluated by measuring relapse rates and drug safety.

Results. Seventy-three patients were included in each group. During the first 45 days after treatment, the percentage of patients with relapse was significantly higher in the 30-day group than in the 45-day group (12.3% vs. 1.37%; relative risk, 9.00; 95% confidence interval [CI], 1.17–69.2; P = .017). Between day 45 after treatment and 12 months after treatment, no further significant differences were found in relapse rates between groups (9.38% in the 30-day group vs. 11.11% in the 45-day group; relative risk, 0.84; 95% CI, 0.31–2.30; P = .78). Overall, relapses occurred in 15 (20.55%) of 73 patients in the 30-day group and in 9 (12.33%) of 73 patients in the 45-day group (relative risk, 1.67; 95% CI, 0.78–3.56; P = .264). Compliance and adverse effects were comparable in the 2 groups.

Conclusions. Doxycycline treatment for 45 days significantly decreased early relapse rates among adults with brucellosis without increasing adverse effects.

Journal Article.  4042 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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