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Efficacy and Tolerability of Antibiotic Combinations in Neurobrucellosis Results of the Istanbul Study        
Yazarlar
Hakan Erdem
Gülhane Askeri Tıp Akademisi, Türkiye
Ayşegül Ulu Kılıç
Erciyes Üniversitesi, Türkiye
Selim Kılıç
Gülhane Askeri Tıp Akademisi, Türkiye
Prof. Dr. Mustafa Kasım KARAHOCAGİL Prof. Dr. Mustafa Kasım KARAHOCAGİL
Yüzüncü Yıl Üniversitesi, Türkiye
Shehata Ghaydaa
Necla Eren Tülek
Funda Yetkin
İnönü Üniversitesi, Türkiye
Mustafa Kemal Çelen
Dicle Üniversitesi, Türkiye
Nurgül Ceran
Hanefi Cem Gül
Gürkan Mert
Suda Tekin Koruk
Murat Dizbay
Gazi Üniversitesi, Türkiye
İnal A Yşe Seza
Saygın Nayman-Alpat
Mile Bosilkovski
Dilara İnan
Akdeniz Üniversitesi, Türkiye
Neşe Saltoğlu
İstanbul Üniversitesi, Türkiye
Laila Abdel Baky
Marıa Teresa Adeva Bartolome
Bahadır Ceylan
İstanbul Medipol Üniversitesi, Türkiye
Suzan Saçar
Çanakkale Onsekiz Mart Üniversitesi, Türkiye
Vedat Turhan
Gülhane Askeri Tıp Akademisi, Türkiye
Emel Yılmaz
Uludağ Üniversitesi, Türkiye
Nazif Elaldı
Cumhuriyet Üniversitesi, Türkiye
Zeliha Koçak Tufan
Yıldırım Beyazıt Üniversitesi, Türkiye
Kenan Uğurlu
Başak Dokuzoğuz
Hava Yılmaz
Ondokuz Mayıs Üniversitesi, Türkiye
Sibel Gündeş
Kocaeli Üniversitesi, Türkiye
Hatice Rahmet Güner
Yıldırım Beyazıt Üniversitesi, Türkiye
Nail Ozgüneş
Asım Ulcay
Serhat Ünal
Hacettepe Üniversitesi, Türkiye
Saim Dayan
Dicle Üniversitesi, Türkiye
Levent Görenek
Gülhane Askeri Tıp Akademisi, Türkiye
Ahmet Karakaş
Yeşim Taşova
Çukurova Üniversitesi, Türkiye
Gaye Usluer
Eskişehir Osmangazi Üniversitesi, Türkiye
Yaşar Bayındır
İnönü Üniversitesi, Türkiye
Behice Kurtaran
Çukurova Üniversitesi, Türkiye
Osman Hakan Leblebicioğlu
Ondokuz Mayıs Üniversitesi, Türkiye
Özet
No data on whether brucellar meningitis or meningoencephalitis can be treated with oral antibiotics or whether an intravenous extended-spectrum cephalosporin, namely, ceftriaxone, which does not accumulate in phagocytes, should be added to the regimen exist in the literature. The aim of a study conducted in Istanbul, Turkey, was to compare the efficacy and tolerability of ceftriaxone-based antibiotic treatment regimens with those of an oral treatment protocol in patients with these conditions. This retrospective study enrolled 215 adult patients in 28 health care institutions from four different countries. The first protocol (P1) comprised ceftriaxone, rifampin, and doxycycline. The second protocol (P2) consisted of trimethoprim-sulfamethoxazole, rifampin, and doxycycline. In the third protocol (P3), the patients started with P1 and transferred to P2 when ceftriaxone was stopped. The treatment period was shorter with the regimens which included ceftriaxone (4.40 +/- 2.47 months in P1, 6.52 +/- 4.15 months in P2, and 5.18 +/- 2.27 months in P3) (P = 0.002). In seven patients, therapy was modified due to antibiotic side effects. When these cases were excluded, therapeutic failure did not differ significantly between ceftriaxone-based regimens (n = 5/166, 3.0%) and the oral therapy (n = 4/42, 9.5%) (P = 0.084). The efficacy of the ceftriaxone-based regimens was found to be better (n = 6/166 [3.6%] versus n = 6/42 [14.3%]; P = 0.017) when a composite negative outcome (CNO; relapse plus therapeutic failure) was considered. Accordingly, CNO was greatest in P2 (14.3%, n = 6/42) compared to P1 (2.6%, n = 3/ 117) and P3 (6.1%, n = 3/ 49) (P = 0.020). Seemingly, ceftriaxone-based regimens are more successful and require shorter therapy than the oral treatment protocol.
Anahtar Kelimeler
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayımlanan tam makale
Dergi Adı ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
Dergi ISSN 0066-4804
Dergi Tarandığı Indeksler SSCI
Makale Dili İngilizce
Basım Tarihi 03-2012
Cilt No 56
Sayı 3
Sayfalar 1523 / 1528
Doi Numarası 10.1128/AAC.05974-11
Makale Linki http://aac.asm.org/cgi/doi/10.1128/AAC.05974-11