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 |
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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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