title: Comparison of doxycycline-streptomycin, doxycycline-rifampin, and ofloxacin-rifampin in the treatment of brucellosis: a randomized clinical trial.
abstract: BACKGROUND
  Traditional regimens for the treatment of brucellosis are associated with significant relapse rates. The aim of this study was to compare the efficacy of ofloxacin plus rifampin (OFX-RIF) versus doxycycline plus streptomycin (DOX-STR) and doxycycline plus rifampin (DOX-RIF) regimens in the treatment of brucellosis.
  
  
  METHODS
  Two hundred and nineteen patients with brucellosis were enrolled in a randomized clinical trial; 28 cases were withdrawn because they did not attend the follow-up. Out of 191 patients with brucellosis, 64 received OFX-RIF, 62 received DOX-RIF, and 65 patients received DOX-STR regimens. All patients were assessed during the period of therapy in the second, fourth, and sixth weeks by clinical course and were also followed up clinically and serologically for 6 months after the cessation of therapy.
  
  
  RESULTS
  The highest clinical response (95.4%) was observed in the DOX-STR group (p=0.009). The results of multivariate analysis indicate that treatment with DOX-STR had the least therapeutic failures among the three groups (p=0.033). Adverse reactions were seen in 16.8% of patients, but there was no significant difference among the three groups (p=0.613). The lowest relapse rate (4.6%) was observed in the DOX-STR group (p=0.109).
  
  
  CONCLUSIONS
  We conclude that the DOX-STR combination should remain the first-line regimen for the treatment of brucellosis in our region; we recommend DOX-RIF and OFX-RIF combinations as the second-line regimens.
authors.affiliation: Department of Infectious Diseases, Hamedan University of Medical Sciences, Hamedan, Iran.
authors.forename: Seyyed Hamid
authors.initials: SH
authors.lastname: Hashemi
authors.forename: Latif
authors.initials: L
authors.lastname: Gachkar
authors.forename: Fariba
authors.initials: F
authors.lastname: Keramat
authors.forename: Mojgan
authors.initials: M
authors.lastname: Mamani
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Hajilooi
authors.forename: Alireza
authors.initials: A
authors.lastname: Janbakhsh
authors.forename: Mohammad Mehdi
authors.initials: MM
authors.lastname: Majzoobi
authors.forename: Hossein
authors.initials: H
authors.lastname: Mahjub
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017347:Brucella melitensis / Q000302:isolation & purification; D002006:Brucellosis / Q000188:drug therapy* / Q000382:microbiology; D004318:Doxycycline / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015242:Ofloxacin / Q000627:therapeutic use*; D012293:Rifampin / Q000627:therapeutic use*; D013307:Streptomycin / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D015242:Ofloxacin; D004318:Doxycycline; D012293:Rifampin; D013307:Streptomycin