Efficacy And Tolerability Of Antibiotic Combinations In Neurobrucellosis: Results Of The Istanbul Study

Autor: Ayşe Seza Inal, Dilara Inan, Saim Dayan, Murat Dizbay, Gaye Usluer, Emel Yilmaz, Gürkan Mert, Nail Ozgunes, Başak Dokuzoğuz, Behice Kurtaran, Serhat Ünal, Mile Bosilkovski, Hakan Erdem, Sibel Gundes, Suzan Sacar, Maria Teresa Adeva-Bartolome, Ghaydaa A. Shehata, Hanefi Cem Gul, Mustafa Kasim Karahocagil, Suda Tekin-Koruk, Ahmet Karakaş, Bahadir Ceylan, Zeliha Kocak-Tufan, Levent Gorenek, Nazif Elaldi, Oğuz Reşat Sipahi, Hava Yilmaz, Nurgul Ceran, Yasar Bayindir, Asim Ulcay, Nese Saltoglu, Kenan Ugurlu, Yeşim Taşova, Funda Yetkin, Aysegul Ulu-Kilic, Rahmet Guner, Laila Abdel-Baky, Necla Eren-Tulek, Mustafa Kemal Çelen, Selim Kilic, Hakan Leblebicioglu, Saygin Nayman-Alpat, Vedat Turhan
Přispěvatelé: İç Hastalıkları, Erdem, H., Kasimpasa Hospital, Department of Infectious Diseases and Clinical Microbiology (IDCM), Istanbul, Turkey -- Ulu-Kilic, A., Erciyes School of Medicine, Department of IDCM, Kayseri, Turkey -- Kilic, S., Gulhane Medical Academy, Department of Public Health, Ankara, Turkey -- Karahocagil, M., Yüzüncü Yil School of Medicine, Department of IDCM, Van, Turkey -- Shehata, G., Assiut University Hospital, Department of Neurology and Psychiatry, Assiut, Egypt -- Eren-Tulek, N., Ankara Training and Research Hospital, Ankara, Turkey -- Yetkin, F., Inonu School of Medicine, Department of IDCM, Malatya, Turkey -- Celen, M.K., Dicle School of Medicine, Department of IDCM, Diyarbakir, Turkey -- Ceran, N., Haydarpasa Numune Training and Research Hospital, Department of IDCM, Istanbul, Turkey -- Gul, H.C., Gulhane School of Medicine, Department of IDCM, Ankara, Turkey -- Mert, G., Gulhane School of Medicine, Department of IDCM, Ankara, Turkey -- Tekin-Koruk, S., Harran School of Medicine, Department of IDCM, Sanliurfa, Turkey -- Dizbay, M., Gazi School of Medicine, Department of IDCM, Ankara, Turkey -- Inal, A.S., Cukurova School of Medicine, Department of IDCM, Adana, Turkey -- Nayman-Alpat, S., Osmangazi School of Medicine, Department of IDCM, Eskisehir, Turkey -- Bosilkovski, M., Skopje Medical Faculty, Department of Infectious Diseases and Febrile Conditions, Skopje, Macedonia -- Inan, D., Akdeniz School of Medicine, Department of IDCM, Antalya, Turkey -- Saltoglu, N., Cerrahpasa School of Medicine, Department of IDCM, Istanbul, Turkey -- Abdel-Baky, L., Assiut University Hospital, Department of Tropical Medicine and Fever, Assiut, Egypt -- Adeva-Bartolome, M.T., Hospital Recoletas Zamora, Zamora, Spain -- Ceylan, B., Istanbul Training and Research Hospital, Department of IDCM, Istanbul, Turkey -- Sacar, S., Pamukkale School of Medicine, Department of IDCM, Denizli, Turkey -- Turhan, V., Haydarpasa Gulhane, Training and Research Hospital, Department of IDCM, Istanbul, Turkey -- Yilmaz, E., Uluda? School of Medicine, Department of IDCM, Bursa, Turkey -- Elaldi, N., Cumhuriyet School of Medicine, Department of IDCM, Sivas, Turkey -- Kocak-Tufan, Z., Ankara Training and Research Hospital, Ankara, Turkey -- U?urlu, K., Ankara Numune Training and Research Hospital, Department of IDCM, Ankara, Turkey -- Dokuzo?uz, B., Ankara Ataturk Training and Research Hospital, Department of IDCM, Ankara, Turkey -- Yilmaz, H., Ondokuz Mayis School of Medicine, Department of IDCM, Samsun, Turkey -- Gundes, S., Kocaeli School of Medicine, Department of IDCM, Kocaeli, Turkey -- Guner, R., Skopje Medical Faculty, Department of Infectious Diseases and Febrile Conditions, Skopje, Macedonia -- Ozgunes, N., Goztepe Training and Research Hospital, Department of IDCM, Istanbul, Turkey -- Ulcay, A., Kasimpasa Hospital, Department of Infectious Diseases and Clinical Microbiology (IDCM), Istanbul, Turkey -- Unal, S., Hacettepe University, Department of Internal Medicine, Ankara, Turkey -- Dayan, S., Dicle School of Medicine, Department of IDCM, Diyarbakir, Turkey -- Gorenek, L., Haydarpasa Gulhane, Training and Research Hospital, Department of IDCM, Istanbul, Turkey -- Karakas, A., Gulhane School of Medicine, Department of IDCM, Ankara, Turkey -- Tasova, Y., Cukurova School of Medicine, Department of IDCM, Adana, Turkey -- Usluer, G., Skopje Medical Faculty, Department of Infectious Diseases and Febrile Conditions, Skopje, Macedonia -- Bayindir, Y., Inonu School of Medicine, Department of IDCM, Malatya, Turkey -- Kurtaran, B., Cukurova School of Medicine, Department of IDCM, Adana, Turkey -- Sipahi, O.R., Ege School of Medicine, Department of IDCM, Izmir, Turkey -- Leblebiciogluz, H., Ondokuz Mayis School of Medicine, Department of IDCM, Samsun, Turkey, Ege Üniversitesi, OMÜ, Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı., Yılmaz, Emel
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Nervous-system brucellosis
Male
Turkey
Antibiotics
Medical record review
Olfactory nerve disease
Meningoencephalitis
Esophagitis
Pharmacology (medical)
Trimethoprim-sulfamethoxazole combination
Treatment outcome
Doxycycline
Depression
Vestibulocochlear nerve disease
Comparative effectiveness
Management
Retrospective study
Drug Therapy
Combination
Rifampin
Human
medicine.medical_specialty
Major clinical study
Side effect
Clinical Therapeutics
Oculomotor nerve disease
Microbiology
Article
Treatment duration
Brain ischemia
Drug substitution
Pharmacotherapy
Hypoglossal nerve disease
Brucellosis
Agglutination Tests
Zoonosis
Humans
Brain hematoma
Aged
Retrospective Studies
Pharmacology
Abducens nerve disease
Antibiotic therapy
medicine.disease
Brucella
Trimethoprim
Cotrimoxazole
Regimen
ComputingMethodologies_PATTERNRECOGNITION
Brucellar meningoencephalitis
Drug eruption
Bacterial meningitis
Administration
Oral
Turkey (republic)
Recurrence
Nausea and vomiting
Diagnosis
Clinical protocol
Visual disorder
Treatment Failure
Pharmacology & Pharmacy
Relapse
Priority journal
Drug tolerability
Drug withdrawal
Ceftriaxone
Middle Aged
Anti-Bacterial Agents
Paresis
Brain abscess
ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS
Infectious Diseases
Tolerability
Gastritis
Injections
Intravenous
Female
InformationSystems_MISCELLANEOUS
Meningitis
Hydrocephalus
medicine.drug
Adult
Adolescent
medicine.drug_class
Optic nerve disease
Therapeutic features
Facial nerve disease
Bacterial-meningitis
Polyneuropathy
Internal medicine
Trimethoprim
Sulfamethoxazole Drug Combination
medicine
Subarachnoid hemorrhage
Rifampicin
business.industry
ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS
Brucellar meningitis
Thrombocytopenia
Surgery
Drug efficacy
Drug treatment failure
Aminotransferase blood level
business
Controlled study
Popis: PubMed ID: 22155822
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. Copyright © 2012, American Society for Microbiology. All Rights Reserved.
Databáze: OpenAIRE
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