Brucellosis treatment plan Brucellosis patients must remember

Brucellosis is a common disease in pastoral areas. It is divided into two infectious periods: acute and chronic. The symptoms of each period are different, so the treatment of brucellosis also needs to be divided into the acute and chronic periods for targeted treatment. Let us take a closer look at the treatment plans for brucellosis in different stages!

1. Acute treatment

(1) General treatment and symptomatic treatment: including bed rest, vitamin and water supplementation. Physical cooling should be applied to patients with high fever, and indomethacin suppository can be used for symptomatic treatment of high fever. Patients with severe headaches and joint pains should use analgesics; patients with obvious poisoning symptoms and severe orchitis can use appropriate amounts of adrenal cortex hormones. Corticosteroids such as prednisone may be given in severe cases. Patients with severe myalgia may require a stronger analgesic such as codeine.

(2) Antimicrobial therapy: Relapse is common when a single antibiotic is used, so combination antibiotic therapy is often given.

① Combination therapy of rifampicin and doxycycline

The daily dose of rifampicin is 600-900 mg; doxycycline 200 mg per day, taken orally in divided doses for 6 weeks, is the preferred option. Tetracycline and rifampicin can also be used in combination therapy.

②Combination therapy of streptomycin and doxycycline

The daily dose of streptomycin is 1g, divided into 1 to 2 intramuscular injections, and the medication lasts for 2 to 4 weeks. Doxycycline 200 mg orally per day, divided into 2 doses, for 6 weeks. Gentamycin or amikacin can also be used instead of streptomycin. Streptomycin can also be used in combination with rifampicin or with tetracycline.

③For Brucella meningitis, chloramphenicol and streptomycin can be used in combination or rifampicin plus clacifloxacin can be used in combination.

④Complex sulfamethoxazole also has a certain effect on this disease. The course of treatment should be 4 to 6 weeks. If it is too short, relapse is likely to occur (relapse rate 4% to 50%). Streptomycin should also be used at the same time. The adult dose is 0.75~1g per kilogram, divided into 2 intramuscular injections, and the course of treatment is 3 weeks. Children younger than 8 years may be given trimethoprim-sulfamethoxazole plus streptomycin or rifampin because tetracycline can damage children's teeth.

2. Treatment of the chronic stage is more complicated and should include pathogen treatment, desensitization therapy and symptomatic treatment.

(1) Pathogen treatment: Patients with acute onset, chronic active, or chronic disease with local lesions or positive bacterial culture all require pathogen treatment. The method is the same as that in the acute phase.

(2) Vaccine treatment: The initial dose is 250,000 bacteria per day, and the dose is gradually increased. By the end of the treatment, the vaccine can reach 150 million bacteria per day. One course of treatment is 10 to 15 days.

(3) Treatment with hydrolysins and lysozymes: The initial dose is 1 mL per day, which can be gradually increased to 2 mL per day. The course of treatment is 10 to 15 days, and it is used in combination with antibiotics.

Prognosis

The prognosis of this disease is generally good, and most patients tend to recover on their own even without treatment. Those who are not treated with antibiotics can generally recover within 1 to 3 months, but they are prone to relapse. The course of the disease is greatly shortened if treated promptly. The main causes of death are endocarditis, severe neurological complications, etc. In a few cases, joint lesions and tendon spasms may remain, limiting limb movement.