Brucellosis, commonly known as "undulant fever" for its fluctuating symptoms, is caused by various bacteria of the genus Brucella that primarily infect livestock like cattle, goats and pigs. It poses health risks, especially in rural agricultural communities and developing nations. As an infectious zoonotic disease (transferred from animals to humans), humans typically acquire brucellosis through direct contact with infected animals or by consuming unpasteurised dairy products. Determining effective brucellosis treatment is important, as outbreaks can and do occur where livestock are unvaccinated. In this article, we'll discuss the options for treatment when human infection does occur.
Treatment of Brucellosis
Usually, the doctor approaches brucellosis treatment using a combination of at least two different antibiotics. The infected person should take the medication for around 6-8 weeks. They may require other therapies to help manage symptoms or complications depending on their particular case.
The antibiotic medications used to cure the disease might include the following:
- Streptomycin or Gentamicin
- Doxycycline
- Rifampin
- Trimethoprim/sulfamethoxazole.
- Ciprofloxacin.
Treatment for Adult Patients
Generally, the first treatment choice for uncomplicated brucellosis in adult patients is a combination of doxycycline-aminoglycoside and doxycycline-rifampin. Furthermore, doxycycline-cotrimoxazole acts as an alternative medication. Sometimes, quinolone oral drugs may also function as an alternative.
Your doctor may also prescribe oral doxycycline, twice a day for 6 weeks, and streptomycin , given once every 12-24 hours (or gentamicin once every day) for 14 days. These medicines help lower the relapse rate.
Other oral dosages that are equally effective include:
- Oral rifampin twice daily for 6 weeks can work instead of aminoglycoside.
- Oral ciprofloxacin regimen twice a day for 14-42 days, plus doxycycline or rifampin instead of aminoglycoside.
Treatment for Younger Patients
For younger patients under 8 years old, treatment includes cotrimoxazole plus rifampin for 6 weeks. Besides, an alternative therapy can consist of gentamicin given for 5 days plus cotrimoxazole for 6 weeks.
Generally, treatment options for brucellosis in children include trimethoprim/sulfamethoxazole (cotrimoxazole) and aminoglycoside (streptomycin, gentamicin) or rifampicin.
Note:
- To prevent recurrence of the disease, you must take antibiotic medication for several weeks. The rate of relapse after treatment ranges around 5-15%. The relapse often occurs within the first 6 months after treatment. Therefore, combination therapy is necessary because the relapse rate tends to be higher with single treatment.
- Depending on how fast you start on treatment, plus the disease’s severity, recovery may take several weeks to some months. However, death due to brucellosis is rare and occurs in at most 2% of all cases.