Comparison of various treatments in childhood brucellosis

Abstract

The aim of this study was to evaluate the effectiveness of different drug combinations for treatment of brucellosis in children. Sixty children (mean age 9.2 ± 3.1 years, range 10 months to 15 years) were treated with four different drug combinations. The diagnosis of brucellosis was established by positive serum agglutination titer, and/or the isolation of Brucella species from blood cultures. The most frequent findings were fever and arthritis in 12 (20%) and 13 (21.6%) patients respectively. The children under 8 years old comprised Group 1 and 2, and older than 8 years comprised Group 3 and 4 according to treatment regimens. Nine patients (Group 1) were treated with trimethoprim-sulfamethoxazole (TMP-SMZ) for 45 days plus ceftriaxone for 5 days and, rest nine patients (Group 2) were managed with TMP-SMZ for 45 days plus gentamicin for 5 days. Twenty-one patients (Group 3) were managed with doxycycline for 45 days and ceftriaxone for 5 days and, other 21 (Group 4) patients were managed with doxycycline for 45 days and gentamicin for 5 days. All patients recovered. Relapse and improvement rates were similar for all groups ( P> 0.05). Each regimen was effective in the treatment of childhood brucellosis. Using cheaper drugs such as doxycycline and gentamicin in children 8 years of age and older, and TMP-SMZ and gentamicin in children 7 years of age or younger for the treatment of brucellosis in children is a practical and useful approach in our region and in the developing countries.