title: Failure of ceftriaxone in the treatment of acute brucellosis.
abstract: In an open, multicenter study conducted in Israel in 1989, 18 patients with acute brucellosis were randomized to receive either less than or equal to 2 g of intramuscularly administered ceftriaxone daily for at least 2 weeks or doxycycline for 4 weeks plus streptomycin for 2 weeks. All 10 patients treated with the combination of doxycycline plus streptomycin responded promptly, and their infections did not relapse during 6 months of follow-up. Of eight patients treated with ceftriaxone, six did not respond initially; when ceftriaxone was replaced by the combination of doxycycline and streptomycin, patients responded immediately. No relapses of infection were observed in these patients during follow-up. One patient who received ceftriaxone responded and remained well at the end of 6 months of follow-up, and one patient who initially responded to therapy with this drug experienced relapse of infection within 3 weeks but recovered when the doxycycline/streptomycin regimen was initiated. We conclude that despite encouraging data from in vitro studies and promising clinical studies, 2 g of ceftriaxone administered im daily should not be considered appropriate therapy for brucellosis.
authors.affiliation: Infectious Diseases Unit, Sapir Medical Center, Kfar-Saba, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Lang
authors.forename: R
authors.initials: R
authors.lastname: Dagan
authors.forename: I
authors.initials: I
authors.lastname: Potasman
authors.forename: M
authors.initials: M
authors.lastname: Einhorn
authors.forename: R
authors.initials: R
authors.lastname: Raz
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002006:Brucellosis / Q000188:drug therapy*; D002443:Ceftriaxone / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016896:Treatment Outcome
chemical_list: D002443:Ceftriaxone