>6 weeks) have the least rates of failure. One study of the treatment of brucellar spondylitis documented that six months of triple therapy were needed to prevent recurrences. Pregnant Women Co-trimoxazole has been used in pregnant women with reported success. Children In pediatric patients older than 12 years, doxycycline (5 mg/kg/day for three weeks) plus gentamicin (5 mg/kg/day IM for the first five days) is the advised therapy. For children younger than 12 years, trimethoprim/sulfamethoxazole (TMP-SMZ) for three weeks and a five-day course of gentamicin are most efficacious. Adults Doxycycline (100 mg PO bd for six weeks) is the most suitable monotherapy in simple infection; but relapse rates may reach 40% for monotherapy treatment. Rifampicin (600-900 mg/day) is typically added to doxycycline for a full six-week course. Doxycycline (six weeks) plus streptomycin (two or three weeks) was a more successful regimen than doxycycline plus rifampicin (six weeks). Streptomycin requires daily intramuscular injections and is more costly than rifampicin. In patients with spondylitis or sacroiliitis, doxycycline plus streptomycin (1 g/day IM for three weeks) was found to be more effective than the doxycycline and rifampicin combination. The quinolone plus rifampicin (6 weeks) regime is somewhat better endured than doxycycline plus rifampicin but there was no difference in efficacy. Corticosteroids may be indicated in CNS infection. Most patients resolve completely if treated early. TABLE OF CONTENT Introduction Chapter 1 Mediterranean Fever Chapt...
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