Definition
Brucellosis is an infectious disease transmitted from animals to humans (anthropozoonosis), especially through the intake of some infected foods; we are talking about a disease that affects millions of victims in the world, tending to resolve only several weeks following the infection.
Causes
The etiopathological agent involved in brucellosis is a gram negative bacterium belonging to the genus Brucella ; the species most involved are Brucella abortus, Brucella suis and Brucella melitensis . These bacteria are transmitted to animals (which act as a reservoir for the pathogen) either directly or indirectly; the man can in turn be infected by eating infected food or, more rarely, by sexual contact.
Most at risk foods: fresh unpasteurized milk, butter, fresh cheeses, ice cream, cream
Symptoms
The symptomatology of brucellosis is characterized by the appearance of fever, which begins after 10-20 days from the infection with an oscillating pattern, alternating high peaks of fever with low-grade fever. In addition to the alteration of body temperature, brucellosis is often accompanied by anorexia, asthenia, chills, diarrhea, muscle and joint pain, loss of appetite, headache, constipation / diarrhea, sweating (even smelly), vomiting.
- Complications: arthritis, endocarditis, epididymitis, orchitis, predisposition to infections of the nervous system (eg encephalitis, meningitis, etc.)
Information on Brucellosis - Drugs for the Treatment of Brucellosis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Brucellosis - Drugs for the treatment of Brucellosis.
drugs
In case of proven Brucella infection, it is recommended to start a therapeutic procedure within the shortest possible time, just to avoid complications, even terrible ones, deriving from a lack of care. Fortunately, this anthropozoonosis is easily resolved with an antibiotic drug therapy, which must be targeted and specific to the patient. Given the resistance to drugs developed by brucella, antibiotic treatment should generally be continued for at least 6 weeks; some particularly sensitive or immunocompromised patients should prolong therapy for a few months.
In addition to antibiotic treatment, the patient may need to take other drugs to control secondary symptoms; for example, when fever - a characteristic symptom of brucellosis - does not decrease after a few days of antibiotic treatment, it is possible to take specific drugs to regulate body temperature. However, it must be emphasized that, at least for the majority of affected patients, the antibiotic is able to lower fever even after a couple of days from the administration.
For the control of secondary symptoms such as constipation, the patient can take drugs or dietary supplements to promote peristalsis, rebalancing the intestinal function. Similar discourse for vomiting: every organism responds in a subjective way to diseases and treatments; when brucellosis affects a particularly sensitive individual, vomiting could be a dangerous phenomenon, as well as very unpleasant, since the patient risks dehydration. In such situations, therefore, we recommend an immediate replenishment of liquids and electrolytes, in addition to the administration of anti-emetic drugs.
Similar to tuberculosis, brucellosis can also recur even long after the (alleged) recovery.
The following are the classes of drugs most used in therapy against brucellosis, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and posology for the patient, based on the severity of the disease, the health of the patient and his response to treatment:
Tetracycline : although this class of antibiotic drugs is by far the most active against Brucella bacteria, it is recommended to combine another antibiotic, since monotherapy could favor new future relapses.
- Doxycycline (eg Doxicicl, Periostat, Miraclin, Bassado): take approximately 100-200 mg per day, in combination with 600-900 mg / day of rifampicin (eg Rifampic, one of the most used drugs for the treatment of tuberculosis). Continue with this method of administration for at least 6 weeks. Alternatively, it is possible to take doxycycline per os combined with streptomycin intramuscularly (at a dose of 1 gram per day, for 21 days)
- Tetracycline (eg Tetrac C, Pensulvit, Ambramycin): for the treatment of brucellosis, take 500 mg of drug orally 4 times a day for 3 weeks. It is recommended to combine streptomycin (eg Strept S FN). At a dose of 1 gram, to be taken intramuscularly, it is recommended to take the drug twice a day for the first week of treatment and once a day for the second week. Do not take streptomycin during pregnancy.
Sulfonamide antibiotics : indicated for the treatment of brucellosis in children. It is possible to associate the drug with a tetracycline, although an increased risk of relapse has been observed; to avoid this, we recommend associating riftrin to Bactrim.
- Sulfamethoxazole / trimethoprim (eg Bactrim): the pharmacological preparation is formulated with two active sulfonamides which, acting in synergy, enhance the therapeutic effect speeding up the healing time of brucellosis. Generally, the sulfamethoxazole and trimethoprim that make up each tablet are formulated in a 5: 1 ratio: for example, one tablet may contain 400 mg of sulfamethoxazole and 80 mg of trimethoprim. Indicatively, take 1 tablet every 12 hours (posology for adults); the treatment time should be established by the doctor, although it is generally estimated around 6 weeks. The drug is used in therapy for the treatment of brucellosis when the use of doxycycline is not indicated for that particular patient.
Aminoglycosides
- Gentamicin (eg. Gentamicin, Ciclozinil, Genbrix, Gentalyn): the drug should be taken at an initial dose of 2mg / kg, followed by 1.7mg / kg intravenously or intramuscularly; alternatively, administer 5 mg / kg intravenously every 24 hours. Administration of gentamicin should be continued for at least 2-3 weeks.
Bacteriostats : indicated to block bacterial proliferation in the context of brucellosis
- Chloramphenicol (eg Vitamin phenolic, Mycetin, Chemicetin): indicated for the treatment of neurological complications from brucellosis: in fact, the drug is able to cross the blood-brain barrier more simply than tetracyclines. The drug is available in the form of syrup or intravenous solution: for adults, administer approximately 1-3 grams per day in the form of syrup (corresponding to about 2 scoops every 4 hours); the indicative dose for children is instead of 1 scoop per day. Alternatively, take the drug intravenously, at a dose of 1-3 g / day for adults and 0.5-1.5 g / day for children, in 2-3 daily doses. Indicated both for the treatment of Salmonellosis and for the treatment of Brucellosis.
Medications to lower fever : in case of particularly persistent fever, paracetamol can be taken
- Paracetamol or acetaminophen (eg. Acetamol, Tachipirina, Efferalgan, Sanipirina, Piros, Tachidol): take the drug in case of fever associated with brucellosis, orally in the form of tablets, syrup, effervescent sachets or suppositories; it is recommended to take paracetamol at a dosage of 325-650 mg every 4-6 hours for 6-8 consecutive days, to bring down the fever. The drug can also be taken intravenously: 1 gram every 6 hours or 650 mg every 4 hours for adults and adolescents weighing more than 50 kilos: if the patient weighs less than 50 kilos, give 15 mg / kg every 6 hours or 12, 5 mg / kg every 4 hours.
Antiemetic drugs : these drugs do not act on the triggering cause (Brucella), rather they speed up the healing of the disease by improving the patient's general health.
In the case of severe vomiting, supplementation with mineral salts (electrolyte therapy) and drinking plenty of fluids is recommended. It is also possible to take some medications to quell vomiting in the context of brucellosis.
For further information: see the article on drugs for the treatment of vomiting.
