Comparing efficacy and safety of high-dose and standard-dose rifampicin in the treatment of brucellosis : a randomized clinical trial

© The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..

BACKGROUND: In a few studies, higher doses of rifampicin improved the outcome of patients with TB. There is no information regarding efficacy and safety of higher doses of rifampicin in patients with brucellosis.

OBJECTIVES: To compare efficacy and safety of higher and standard doses of rifampicin, each with doxycycline, in the treatment of patients with brucellosis.

METHODS: Within a randomized clinical trial, clinical response and adverse events of high-dose rifampicin (900-1200 mg/day) plus doxycycline 100 mg twice daily were compared with standard-dose rifampicin (600 mg/day) plus doxycycline 100 mg twice daily in 120 patients with brucellosis.

RESULTS: Clinical response occurred in 57 (95%) of patients in the high-dose group and 49 (81.66%) of patients in the standard-dose group (P = 0.04). The most common adverse events of the treatment were nausea (37.5%), skin rash (13.33%), vomiting (10%) and transaminitis (7.22%). Incidence of these events was comparable between the groups.

CONCLUSIONS: The rate of clinical response in patients with brucellosis who were treated with high-dose rifampicin plus standard-dose doxycycline was significantly higher than in the patients who received the standard doses of rifampicin and doxycycline, without further adverse events. The high-dose rifampicin therefore improved clinical response in patients with brucellosis with a similar safety profile to the standard dose. If these findings are confirmed in future studies, higher doses of rifampicin may be recommended for treatment of patients with brucellosis.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:78

Enthalten in:

The Journal of antimicrobial chemotherapy - 78(2023), 4 vom: 03. Apr., Seite 1084-1091

Sprache:

Englisch

Beteiligte Personen:

Salehi, Mohammadreza [VerfasserIn]
Farbod, Farnaz [VerfasserIn]
Khalili, Hossein [VerfasserIn]
Rahmani, Hamid [VerfasserIn]
Jafari, Sirous [VerfasserIn]
Abbasi, Ali [VerfasserIn]

Links:

Volltext

Themen:

Anti-Bacterial Agents
Doxycycline
Journal Article
N12000U13O
Randomized Controlled Trial
Rifampin
VJT6J7R4TR

Anmerkungen:

Date Completed 04.04.2023

Date Revised 12.06.2023

published: Print

Citation Status MEDLINE

doi:

10.1093/jac/dkad051

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM353860131