Doxycycline-rifampicin: physicians' inferior choice in brucellosis or how convenience reigns over science.
OBJECTIVE
Brucellosis treatment is based on sub-optimal, not universally implemented regimens (doxycycline-rifampicin and doxycycline-streptomycin). The authors sought to evaluate specialists' and physicians' attitude towards regimens used, non-medical aspects, and future trends in human brucellosis treatment.


METHODS
A questionnaire-based survey of multi-national specialists, physicians, and trainees, was conducted, questionnaire answered following lectures outlining major scientific facts about existing regimens. Responders indicated preference between the two regimens, their opinion on protracted monotherapy or triple regimens of shorter duration, awareness of disease notification and hospitalization practices. Results were evaluated in relation with professional status and experience with the disease.


RESULTS
Although scientifically inferior to doxycycline-streptomycin, doxycycline-rifampicin is the choice regimen for 64.6% of the participants. A shorter triple regimen, but not protracted monotherapy, would be desirable (60.2% and 10.4%, respectively). Low awareness of disease-notifying status and related procedures were recorded in 53.9%.


CONCLUSIONS
When choosing between currently acceptable brucellosis regimens, medical personnel prefer convenience, even at the cost of a slightly higher relapse percentage. Future trials should evaluate shorter triple regimens. Enhancement of awareness on the disease and its principles may increase therapeutic cost effectiveness.
Pappas
G
G
Institute for Continuing Medical Education of Ioannina, H. Trikoupi 10, 45333 Ioannina, Greece. gpele@otenet.gr
Siozopoulou
V
V
Akritidis
N
N
Falagas
M E
ME
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D002006:Brucellosis / Q000188:drug therapy*; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D014943:Global Health; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010818:Practice Patterns, Physicians'; D012293:Rifampin / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004318:Doxycycline; D012293:Rifampin