Antibiotic Therapy of Brucellosis. Current State and Prospects for Improvement

Abstract

Human brucellosis is a particularly dangerous socially significant infection that still poses a serious threat to public health due to a wide range of clinical manifestations, severe course, and the development of serious complications of infection that may lead to disability, which, in turn, causes significant damage to the economy. Treatment issues remain debatable, since the pathogen's ability to cause intracellular parasitism complicates effective antibiotic therapy. The review presents the data on in vitro activity and effic acy when using tetracyclines, rifampicin, fluoroquinolones, aminoglycosides, carbapenems, macrolides, cephalosporins, chloramphenicol, and trimethoprim/sulfamethoxazole as monotherapy agents. The data on the effectiveness of the use of antibacterial drugs in various combinations, and the inclusion of immunomodulators in the treatment regimen are presented. Information concerning promising modern developments that facilitate better penetration of antibacterial drugs into phagocytic cells is considered. Some results of searching for sources of new means of antibacterial therapy of brucellosis are presented.