Erdem, HakanKılıç, Ayşegül UluKılıç, SelimKarahocagil, MustafaShehata, GhaydaaTülek, Necla ErenYetkin, FundaÇelen, Mustafa KemalCeran, NurgülGül, Hanefi CemMert, GürkanKoruk, Suda TekinDizbay, Muratİnal, Ayşe SezaAlpat, Saygın NaymanBosilkovski, Mileİnan, DilaraSaltoğlu, NeşeAbdel-Baky, LailaAdeva-Bartolome, Maria TeresaCeylan, BahadırSaçar, SuzanTurhan, VedatElaldı, NazifTufan, Zeliha KoçakUğurlu, KenanDokuzoğuz, BaşakYılmaz, HavaGündeş, SibelGüner, RahmetÖzgüneş, NailUlçay, AsımÜnal, SerhatDayan, SaimGörenek, LeventKarakaş, AhmetTasova, YeşimUsluer, GayeBayındır, YaşarKurtaran, BehiceSipahi, Oğuz ReşatLeblebicioğlu, Hakan2022-02-282022-02-282012-03Erdem, H. vd. (2012). "Efficacy and tolerability of antibiotic combinations in Neurobrucellosis: Results of the Istanbul study". Antimicrobial Agents and Chemotherapy, 56(3), 1523-1528.0066-48041098-6596https://doi.org/10.1128/AAC.05974-11https://journals.asm.org/doi/10.1128/AAC.05974-11http://hdl.handle.net/11452/24719No 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.eninfo:eu-repo/semantics/openAccessMicrobiologyPharmacology & pharmacyNervous-system brucellosisBacterial-meningitisTherapeutic featuresManagementDiagnosisTurkeyAdministration, oralAdolescentAdultAgedAnti-bacterial agentsBrucellaBrucellosisCeftriaxoneDoxycyclineDrug therapy, combinationFemaleHumansInjections, intravenousMaleMeningitisMeningoencephalitisMiddle agedRecurrenceRetrospective studiesRifampinTreatment failureTrimethoprim-sulfamethoxazole combinationTurkeyArticle0003006233000492-s2.0-848571611231523152856322155822MicrobiologyPharmacology & pharmacyBrucellosis; Agglutination Tests; ZoonosisCeftriaxoneCotrimoxazoleDoxycyclineRifampicinAbducens nerve diseaseAdultAminotransferase blood levelAntibiotic therapyArticleBacterial meningitisBrain abscessBrain hematomaBrain ischemiaBrucellar meningitisBrucellar meningoencephalitisBrucellosisClinical protocolComparative effectivenessControlled studyDepressionDrug efficacyDrug eruptionDrug substitutionDrug tolerabilityDrug treatment failureDrug withdrawalEsophagitisFacial nerve diseaseFemaleGastritisHumanHydrocephalusHypoglossal nerve diseaseMajor clinical studyMaleMedical record reviewNausea and vomitingOculomotor nerve diseaseOlfactory nerve diseaseOptic nerve diseaseParesisPolyneuropathyPriority journalRelapseRetrospective studySide effectSubarachnoid hemorrhageThrombocytopeniaTreatment durationTreatment outcomeTurkey (republic)Vestibulocochlear nerve diseaseVisual disorder