Treatment of brucella spondylitis: lessons from an impossible meta-analysis and initial report of efficacy of a fluoroquinolone-containing regimen.
Although spondylitis is the most common of the complications of brucellosis, and is often debilitating and difficult to treat, there is no consensus on the preferred combination of antibiotics used. We attempted to perform a meta-analysis based on series on brucellar spondylitis published in the last 22 years. Meta-analysis was aborted largely due to insufficient data recorded in most series. However, useful conclusions could be drawn, such as the importance of prolonged treatment, usually more than 12 weeks. No antibiotic combination was proven to be superior, but 14 different regimens were used in the series studied. The authors propose the use of a combination of doxycycline and ciprofloxacin for a period of 3 months, and report the successful use of such a combination in five patients with brucellosis and spondylitis.
Pappas
Georgios
G
Internal Medicine Department, University Hospital of Ioannina, 45110 Ioannina, Greece. gpele@otenet.gr
Seitaridis
Savvas
S
Akritidis
Nikolaos
N
Tsianos
Epaminondas
E
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002002:Brucella / Q000472:pathogenicity*; D002006:Brucellosis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D024841:Fluoroquinolones / Q000494:pharmacology / Q000627:therapeutic use*; D015201:Meta-Analysis as Topic; D013166:Spondylitis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D004318:Doxycycline