title: Failure of a short-term antibiotic therapy for human brucellosis using ciprofloxacin. A study on in vitro susceptibility of Brucella strains.
abstract: BACKGROUND
  Human brucellosis is characterized byfocal complications, chronic courses, and therapeutic failures.
  
  
  METHODS
  In a relapsed case of brucellosis after short-term antibiotic therapy using doxycycline and ciprofloxacin two Brucella strains were isolated, before and after treatment. In vitro susceptibilities of both isolates were determined by E tests including a great variety of antibiotics. In a killing rate experiment the bactericidal activities of doxycycline, streptomycin, rifampin and ciprofloxacin as single agents and in combinations were determined.
  
  
  RESULTS
  Lowest MIC values were measured for doxycycline and ciprofloxacin. MICs did not change under therapy. Streptomycin alone exhibited the most effective killing within 6 h, whereas the other single agents did not show bactericidal activity. Doxycycline plus ciprofloxacin was the most active combination in vitro.
  
  
  CONCLUSIONS
  Routine susceptibility testing of Brucellae is not obligatory as most of the 'traditional' anti-Brucella antibiotics are active in vitro and bactericidal efficacy may differ in vivo.
authors.affiliation: Department of Bacteriology, Bundeswehr Institute of Microbiology, Munich, Germany. SaschaAlDahouk@bundeswehr.org
authors.forename: Sascha
authors.initials: S
authors.lastname: Al Dahouk
authors.forename: Ralf M
authors.initials: RM
authors.lastname: Hagen
authors.forename: Karsten
authors.initials: K
authors.lastname: Nockler
authors.forename: Herbert
authors.initials: H
authors.lastname: Tomaso
authors.forename: Martina
authors.initials: M
authors.lastname: Wittig
authors.forename: Holger C
authors.initials: HC
authors.lastname: Scholz
authors.forename: Gilles
authors.initials: G
authors.lastname: Vergnaud
authors.forename: Heinrich
authors.initials: H
authors.lastname: Neubauer
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002006:Brucellosis / Q000188:drug therapy*; D002939:Ciprofloxacin / Q000494:pharmacology* / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012008:Recurrence; D017211:Treatment Failure
chemical_list: D000890:Anti-Infective Agents; D002939:Ciprofloxacin