title: Treatment outcomes of human bartonellosis: a systematic review and meta-analysis.
abstract: BACKGROUND
  Bartonella henselae, Bartonella quintana, and Bartonella bacilliformis are responsible for the majority of cases of bartonellosis in humans. These species have various unique epidemiologic characteristics, clinical manifestations, and treatment approaches. The objective of this study was to summarize the evidence on the treatment for the three most common species of Bartonella in humans.
  
  
  METHODS
  We searched electronic databases through August 2011 for randomized controlled trials and observational studies designed to evaluate the efficacy and safety of the regimens used to treat diseases produced by B. henselae, B. quintana, and B. bacilliformis. Study selection and appraisal were done in duplicate.
  
  
  RESULTS
  We found two randomized and seven non-randomized studies at high risk of bias. For cat scratch disease, antibiotics did not significantly affect the cure rate or time to achieve cure. In chronic bacteremia, gentamicin and doxycycline significantly increased the resolution rate. The recommended treatment was not better than other regimens for infectious endocarditis and bacillary angiomatosis.
  
  
  CONCLUSIONS
  Current clinical practice for the treatment of bartonellosis relies mostly on expert opinion and antimicrobial susceptibility data. Randomized controlled trials are needed in the field to compare different treatment options.
authors.affiliation: Knowledge and Evaluation Research Unit (KER), Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Unidad de Conocimiento y Evidencia (CONEVID), Universidad Peruana Cayetano Heredia, Lima, Peru. Electronic address: prutskylopez.gabriela@mayo.edu.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Prutsky
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Domecq
authors.forename: Laura
authors.initials: L
authors.lastname: Mori
authors.forename: Serge
authors.initials: S
authors.lastname: Bebko
authors.forename: Melissa
authors.initials: M
authors.lastname: Matzumura
authors.forename: Amar
authors.initials: A
authors.lastname: Sabouni
authors.forename: Anas
authors.initials: A
authors.lastname: Shahrour
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Erwin
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Boyce
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
authors.forename: German
authors.initials: G
authors.lastname: Malaga
authors.forename: M Hassan
authors.initials: MH
authors.lastname: Murad
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001473:Bartonella / Q000187:drug effects*; D001474:Bartonella Infections / Q000188:drug therapy*; D004318:Doxycycline / Q000494:pharmacology / Q000627:therapeutic use; D005839:Gentamicins / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D064887:Observational Studies as Topic; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D004318:Doxycycline
keywords: Antibiotic treatment; Bacillary angiomatosis; Bartonella bacilliformis; Bartonella henselae; Bartonella quintana; Bartonellosis; Cat scratch disease