Comparison of three different regimens in the treatment of acute brucellosis: a multicenter multinational study.

The present study was undertaken to evaluate efficacy, safety and patient acceptability of three antibiotic regimens for the treatment of acute brucellosis. Six different centres were involved: three in France, one in Greece and two in Spain. The regimens were: oral rifampicin 900 mg/day plus oral doxycycline 200 mg/day for 45 days (A), oral doxycycline 200 mg/day for 45 days plus im streptomycin 1 g/day for 21 days (regimen B) [corrected] and the WHO regimen (C) combining oral tetracycline 2 g/day for 21 days plus im streptomycin, 1 g/day, for 14 days. Regimens A and B were randomly allocated in all centres, while regimen C was allocated only in two centres. All patients were suffering from acute brucellosis clinically and biologically proven. 143 patients were allocated for treatment and analysed. Their mean age was 41 years (range 13-70), 49 were female and 94 male, and their mean weight was 64 kg (range 35-98). Among these patients, 14% had localized disease (nine orchitis, eight osteo-articular involvement and one pleural effusion), but there was no statistical difference between the three regimens in regard to this localized disease. Forty-five per cent of the patients had positive blood cultures. The cure rate with regimen A was 95%, 96% with regimen B and 59% with regimen C. Thus regimen A presented the same efficacy rate as regimen B, but regimen C cannot be regarded as the treatment of choice for acute brucellosis.

[Epidemiology of Brucellosis. Trial evaluation of the incidence of clinical and infraclinical forms (author's transl)]. / Epidémiologie des brucelloses. Essai d'évaluation de l'incidence des formes cliniques et infracliniques.

The incidence of clinical and infraclinical human brucellosis was estimated by survey undertaken in 1976 on a representative sample of the population of the Vaucluse (France) district. It is shown that, by combining research of late hypersensitivity and serologic tracking in 2084 individuals, the incidence of diagnosed clinical brucellosis, in the Vaucluse district is at least 3 to 5 times more important than the incidence evaluated by the official notifications, and that there are 10 times more infraclinical or non diagnosed brucellosis than diagnosed brucellosis. The results show the need of triple investigation by interview, serology and hypersensitivity test (complementarity of the three technics) so as to evaluate the true morbidity of this anthropozoonosis.