title: Outcomes of treatment in 50 cases with spinal brucellosis in Babol, Northern Iran.
abstract: BACKGROUND
  Duration of treatment for brucellar spondylitis in endemic regions is controversial. This study describes the outcome of treatment in 50 cases of brucellar spondylitis in Iran.
  
  
  METHODS
  From April 2001 to September 2010, we treated 20, 13, 11 and 6 cases with doxycycline plus rifampin (DR), streptomycin plus doxycycline plus rifampin (SDR), cotrimoxazole plus doxycycline plus rifampin (CDR), and gentamicin plus doxycycline plus rifampin (GDR), respectively. Gentamicin and streptomycin were administered for 14 days and the other agents for 3 months. When complete clinical response was not achieved, therapy was continued. All patients were followed for one year. The Kaplan Meier method and the log rank test were used to compare the duration of therapy between SDR plus GDR patients with those treated with CDR or DR.
  
  
  RESULTS
  Eight (45%), 10 (76.9%), 7 (63.3%) and 6 (100%) cases treated for three months were cured with DR, SDR, CDR and GDR, respectively. Nine (45%), 4 (36.4%) and two (22.2%) were cured after four months with DR, CDR and SDR, respectively. Mean duration of therapy in the SDR plus GDR, CDR and DR was 3.26 ± 0.17, 3.36 ± 0.15 and 3.9 ± 0.23 months, respectively (p=0.49 and p=0.015, respectively). Three cases with epidural or paravertebral abscesses recovered after six months. Relapse occurred in one (9.1%) and two (10%) cases treated with CDR and DR, respectively.
  
  
  CONCLUSIONS
  Brucellar spondylitis could be treated using different combinations of antimicrobials especially with a regimen containing aminoglycoside for four months; patients with epidural or paravertebral abscesses require longer treatment times.
authors.affiliation: Shahid Beheshti Hospital, Babol Medical University, Babol, Iran. smsnganji@yahoo.com
authors.forename: Seyed Mokhtar
authors.initials: SM
authors.lastname: Smailnejad Gangi
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Hasanjani Roushan
authors.forename: Nasser
authors.initials: N
authors.lastname: Janmohammadi
authors.forename: Raheleh
authors.initials: R
authors.lastname: Mehraeen
authors.forename: Mohammad Jafar
authors.initials: MJ
authors.lastname: Soleimani Amiri
authors.forename: Elham
authors.initials: E
authors.lastname: Khalilian
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002006:Brucellosis / Q000188:drug therapy*; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D013166:Spondylitis / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents