Ciprofloxacin and rifampicin versus doxycycline and rifampicin in the treatment of brucellosis.

The present study was undertaken to evaluate the efficacy, safety, and patient tolerability of two antibiotic regimens for the treatment of brucellosis: rifampicin 600 mg/day and doxycycline 200 mg/day for 45 days (group 1), versus rifampicin 600 mg/day and ciprofloxacin 1 g/day for 30 days (group 2). Forty patients were diagnosed with brucellosis based on clinical and microbiological findings. The two groups were comparable regarding age and sex distribution. The average number of days without fever and symptoms was lower in group 2 patients than in group 1 patients (mean+/-SD: 3.85+/-1.98 for group 1 vs. 2.78+/-1.03 for group 2, P=0.044). During the 1-year follow-up period, three (15%) patients in group 2 and two (10%) patients in group 1 had clinical relapses; these rates were not significantly different. Ciprofloxacin and rifampicin treatment for brucellosis is as effective as the standard regimen of doxycycline and rifampicin and offers the advantage of a shorter duration of treatment.

The role of HBV DNA and liver histopathology in HBsAg carriers.

BACKGROUND/AIMS: In this study, we evaluated the association among serum transaminase values, seropositivity of HBV DNA and liver histopathology of patients with positive HBsAg and HBe antibodies. METHODOLOGY: Thirty-five patients were placed in two groups according to their serum transaminase values. Patients with normal transaminase values were evaluated in the first group. The patients with above normal transaminase values were subjected in the second group. RESULTS: In the first group of patients with normal transaminase values, biopsy-proven moderate or severe chronic hepatitis was not observed. HBV DNA seropositivity was 53.3% in this group. Forty-five percent of the patients with above normal transaminase values had moderate chronic hepatitis and seropositivity for HBV DNA in this group was 55%. Our results supported the association between transaminase values and liver pathology, but no statistically significant association was shown between seropositivity of HBV DNA and liver pathology. CONCLUSION: There is much to be studied to understand the function of HBV DNA in the follow up of HBsAg carriers, and liver biopsy has to be used routinely in the follow up of asymptomatic carriers when they happen to have high transaminase values.

Single dose ciprofloxacin in cholera.

To explore the efficacy of single dose ciprofloxacin therapy in cholera, a randomized, open, controlled clinical trial was carried out. Seventy-four adult patient with positive Vibrio cholerae 01 isolates were assigned to receive either ciprofloxacin in a single dose of 1 g (CIP1), or ciprofloxacin 500 mg b.i.d., for 1 day (CIP2), or doxycycline 100 mg b.i.d., for 3 days (D), or, for control, no antibiotics. Mean liquid stool output volume did not show any statistically significant difference among CIP1, CIP2 and doxycycline groups The mean duration of diarrhoea in CIP1 group, on the other hand, was significantly lower than that from the D group (p = 0.004), and the control group (p < 0.001). Bacteriologic clearance at the fourth day of treatment were 95.2% for CIP1, 89.5% for CIP2, 90.5% for D group and 15.4% for the control group. We conclude that a single 1 g ciprofloxacin dose is equivalent to doxycycline in its bacteriologic success but has advantages in shortening the duration of diarrhoea and simplicity of use as a single dose.

Comparison of two regimens for ciprofloxacin treatment of enteric infections.

A clinical trial was conducted in 50 patients with blood cultures positive for Salmonella typhi or Salmonella paratyphi to compare treatment with ciprofloxacin for seven days, 500 mg b.i.d. (Group 1, 25 patients), with treatment for ten days, 750 mg b.i.d. (Group 2, 25 patients). Clinical cure was defined as defervescence of fever by day 5 of treatment, with an absence of complications and no clinical relapse. The clinical cure rate was 84% for group 1 and 96% for group 2; the difference in these rates was not statistically significant. The blood cultures of all patients were sterile by day 2 of treatment and remained so until the sixth month of follow-up. It was concluded that ciprofloxacin treatment for ten days in enteric fever is not necessary. Further studies are needed to evaluate the efficacy of shortening the duration of antibiotic therapy.