ANTIBIOTICS IN THE MANAGEMENT OF BRUCELLOSIS

Abstract

Brucellosis is the most common zoonotic bacterial infection in the world. The causative organism is Brucella spp. and the incubation of period is 5 days to 5 months. Although immunological tests are widely used for the diagnosis but cultures of the blood or other clinical specimens is the gold standard for the diagnosis. Outbreaks of brucellosis occur from time to time. It spreads mostly in the communities having close contact with the sheep and cattle, like farmers, cattle grazers, veterinary workers, and butchers. In the urban situation the outbreaks usually occur due to consumption of unpasteurized milk or its products. The clinical features of brucellosis are protean but the major one is a prolonged fever. Infected animals are the reservoirs and the sources of infection. Antibiotics have a major role in the management of brucellosis. Although a single antibiotic may be effective but a combination is preferred to prevent the chances of development of resistance and recurrence of disease. Antibiotics commonly used in the management of brucellosis are doxycycline, rifampicin, streptomycin, fluoroquinolones, cotrimoxazole, and chloramphenicol. Resistance to one or the other antibiotic have been reported from time to time. Dual therapy is commonly prescribed and triple therapy is used in serious conditions like neuro-brucellosis, endocarditis, or recurrence. The objective of this review was to evaluate the effects of various antibiotic regimens in the management of brucellosis. Antibiotic resistance is a problem which can aggravate the situation in future. We suggest that antibiotics’ use should be rationalized to prevent future drug resistance. At least dual therapy should be used to prevent the chances of recurrence and triple therapy for complicated cases and in cases of relapse. There should be no compromise on the optimal doses and duration of therapy.