51. Update on treatment options for spinal brucellosis
- Author
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Serkan Dayan, Özcan Deveci, Ali Karakas, Serda Gulsun, Ayten Kadanali, Burcu Ceylan, Türker Türker, Ayşe Seza Inal, Vedat Turhan, Elif Sahin Horasan, Recep Tekin, Asuman Inan, Derya Ozturk Engin, Hakan Erdem, Gül Karagöz, Özlem Ak, Uner Kayabas, Selma Alabay, Esra Kazak, Fazilet Duygu, Hanefi Cem Gul, Oguz Karabay, Hayati Demiraslan, Nese Saltoglu, Nazif Elaldi, Çiğdem Kader, Ahmet Sener, Aysegul Ulu-Kilic, Hale Turan, Mehtap Aydin, Tıp Fakültesi, Ulu-Kilic, A, Karakas, A, Erdem, H, Turker, T, Inal, AS, Ak, O, Turan, H, Kazak, E, Inan, A, Duygu, F, Demiraslan, H, Kader, C, Sener, A, Dayan, S, Deveci, O, Tekin, R, Saltoglu, N, Aydin, M, Horasan, ES, Gul, HC, Ceylan, B, Kadanali, A, Karabay, O, Karagoz, G, Kayabas, U, Turhan, V, Engin, D, Gulsun, S, Elaldi, N, Alabay, S, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Karabay, Oğuz, [Ulu-Kilic, A. -- Demiraslan, H.] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol IDCM, Kayseri, Turkey -- [Karakas, A. -- Gul, H. C.] Gulhane Mil Med Acad, Dept IDCM, Ankara, Turkey -- [Erdem, H. -- Turhan, V.] GATA Haydarpasa Training Hosp, Dept IDCM, Istanbul, Turkey -- [Turker, T.] Gulhane Mil Med Acad, Dept Publ Hlth, Ankara, Turkey -- [Inal, A. S.] Cukurova Sch Med, Dept IDCM, Adana, Turkey -- [Ak, O.] Dr Lutfi Kirdar Training & Res Hosp, Dept IDCM, Istanbul, Turkey -- [Turan, H.] Baskent Univ, Sch Med, Dept IDCM, Konya, Turkey -- [Kazak, E.] Uludag Univ, Sch Med, Dept IDCM, Bursa, Turkey -- [Inan, A. -- Engin, D.] Haydarpasa Numune Training & Res Hosp, Dept IDCM, Istanbul, Turkey -- [Duygu, F.] Gaziosmanpasa Univ, Sch Med, Dept IDCM, Tokat, Turkey -- [Kader, C.] Bozok Univ, Sch Med, Dept IDCM, Yozgat, Turkey -- [Sener, A.] Bozok Univ, Sch Med, Dept IDCM, Yozgat, Turkey -- [Dayan, S. -- Deveci, O. -- Tekin, R.] Dicle Univ, Sch Med, Dept IDCM, Diyarbakir, Turkey -- [Saltoglu, N.] Istanbul Univ, Cerrahpasa Med Sch, Dept IDCM, Istanbul, Turkey -- [Aydin, M.] Balikesir Univ, Sch Med, Dept IDCM, Balikesir, Turkey -- [Horasan, E. S.] Mersin Univ, Sch Med, Dept IDCM, Mersin, Turkey -- [Ceylan, B.] Bezmialem Vakif Univ, Dept IDCM, Istanbul, Turkey -- [Kadanali, A. -- Karagoz, G.] Umraniye Training & Res Hosp, Dept IDCM, Istanbul, Turkey -- [Karabay, O.] Sakarya Univ, Sch Med, Dept IDCM, Sakarya, Turkey -- [Kayabas, U.] Inonu Univ, Sch Med, Dept IDCM, Malatya, Turkey -- [Gulsun, S.] Diyarbakir Training & Res Hosp, Dept IDCM, Diyarbakir, Turkey -- [Elaldi, N.] Cumhuriyet Univ, Sch Med, Dept IDCM, Sivas, Turkey -- [Alabay, S.] Erciyes Univ, Sch Med, Dept IDCM, Kayseri, Turkey, Inal, Ayse Seza -- 0000-0002-1182-7164, Karakas, Ahmet -- 0000-0002-0553-8454, Karabay, Oguz -- 0000-0003-0502-432X, and Elaldi, Nazif -- 0000-0002-9515-770X
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Adult ,Male ,Microbiology (medical) ,Spondylodiscitis ,Adolescent ,Epidural abscess ,Brucellosis ,Young Adult ,Ulu-Kilic A., Karakas A., Erdem H., Turker T., Inal A. S. , Ak O., Turan H., Kazak E., Inan A., Duygu F., et al., -Update on treatment options for spinal brucellosis-, CLINICAL MICROBIOLOGY AND INFECTION, cilt.20, 2014 ,medicine ,Humans ,Abscess ,Aged ,Retrospective Studies ,spondylitis ,spondylodiscitis ,treatment ,Aged, 80 and over ,Doxycycline ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Anti-Bacterial Agents ,Treatment ,Aminoglycosides ,Treatment Outcome ,Infectious Diseases ,Tolerability ,Streptomycin ,Anesthesia ,Drug Therapy, Combination ,Female ,Rifampin ,business ,spinal brucellosis ,Rifampicin ,medicine.drug ,Spondylitis - Abstract
WOS: 000329585200001, PubMed ID: 24118178, We evaluated the efficacy and tolerability of antibiotic regimens and optimal duration of therapy in complicated and uncomplicated forms of spinal brucellosis. This is a multicentre, retrospective and comparative study involving a total of 293 patients with spinal brucellosis from 19 health institutions. Comparison of complicated and uncomplicated spinal brucellosis was statistically analysed. Complicated spinal brucellosis was diagnosed in 78 (26.6%) of our patients. Clinical presentation was found to be significantly more acute, with fever and weight loss, in patients in the complicated group. They had significantly higher leukocyte and platelet counts, erythrocyte sedimentation rates and C-reactive protein levels, and lower haemoglobulin levels. The involvement of the thoracic spine was significantly more frequent in complicated cases. Spondylodiscitis was complicated, with paravertebral abscess in 38 (13.0%), prevertebral abscess in 13 (4.4%), epidural abscess in 30 (10.2%), psoas abscess in 10 (3.4%) and radiculitis in 8 (2.7%) patients. The five major combination regimens were: doxycycline 200mg/day, rifampicin 600mg/day and streptomycin 1g/day; doxycycline 200mg/day, rifampicin 600mg/day and gentamicin 5mg/kg; doxycycline 200mg/day and rifampicin 600mg/day; doxycycline 200mg/day and streptomycin 1g/day; and doxycycline 200mg/day, rifampicin 600mg/day and ciprofloxacin 1g/day. There were no significant therapeutic differences between these antibiotic groups; the results were similar regarding the complicated and uncomplicated groups. Patients were mostly treated with doxycycline and rifampicin with or without an aminoglycoside. In the former subgroup, complicated cases received antibiotics for a longer duration than uncomplicated cases. Early recognition of complicated cases is critical in preventing devastating complications. Antimicrobial treatment should be prolonged in complicated spinal brucellosis in particular.
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- 2014