title: Comparison of two durations of triple-drug therapy in patients with uncomplicated brucellosis: A randomized controlled trial.
abstract: BACKGROUND
  Brucellosis remains the most common zoonotic disease throughout the world and especially in Iran. Several clinical trials have tested different therapeutic regimens for brucellosis, but few have assessed the optimal duration of treatment.
  
  
  METHODS
  We performed a randomized controlled trial to compare a triple-drug regimen of doxycycline plus rifampicin for 6 weeks and streptomycin for the first 7 days with doxycycline plus rifampicin for 8 weeks and streptomycin for 7 days in patients with uncomplicated brucellosis in Arak, Iran. The primary outcome measure for the treatment groups was the relapse rate measured at 1, 3, 6, 12, and 24 months after cessation of therapy.
  
  
  RESULTS
  Eligible patients were randomized to one of the 2 groups with 72 per arm. We found no significant difference in the relapse rate for the 8-week treatment group compared to the 6-week group (9.7% vs 13.9%). There were no significant differences between the 6-week and 8-week groups regarding the relapse rate, period between clinical presentation and beginning of treatment, and time of relapse. Symptom resolution was achieved in all cases at a median 9.5 days and no cases experienced continuing symptoms after treatment.
  
  
  CONCLUSIONS
  Our trial found no significant difference between 6-week and 8-week regimens of doxycycline and rifampicin plus streptomycin for the first 7 days. Further comparative studies with a large sample size should be implemented to achieve a consistent therapeutic regimen for uncomplicated brucellosis, to help identify those who may benefit from longer treatment, and to minimize adverse effects and unnecessary continuation of treatment.
authors.affiliation: From the Tuberculosis and Pediatric Infectious Research Center (TPIRC), Arak University of Medical Sciences , Arak , Iran.
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Sofian
authors.forename: Ali-Akbar
authors.initials: AA
authors.lastname: Velayati
authors.forename: Arezoo
authors.initials: A
authors.lastname: Aghakhani
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
authors.forename: Ali-Asghar
authors.initials: AA
authors.lastname: Farazi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Banifazl
authors.forename: Ali
authors.initials: A
authors.lastname: Eslamifar
authors.forename: Amitis
authors.initials: A
authors.lastname: Ramezani
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002006:Brucellosis / Q000188:drug therapy*; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D012293:Rifampin / Q000627:therapeutic use; D013307:Streptomycin / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline; D012293:Rifampin; D013307:Streptomycin
keywords: Brucellosis; Iran; relapse; treatment duration