The gold standard for brucellosis treatment is aggressive combination therapy with two antibiotics to kill the bacteria that cause the infection and suppress their recurrence. Treatment can also involve supportive care for patients who develop complications. This condition is very rare in humans, and a doctor may recommend an epidemiology investigation to find out how a patient contracted it for the purpose of determining if precautions like a food recall are necessary to prevent the spread of disease.
People contract brucellosis from infected animal products. The bacteria enter the body and cause fever, headaches, sweating, and nausea. The bacteria will incubate inside the cells, making it necessary to pursue a course of therapy for several bacterial lifetimes to make sure they are all dead. If the doctor does not treat aggressively, brucellosis infection can become chronic.
Basic brucellosis treatment consists of at least six weeks of doxycycline and rifampin. A doctor may also consider streptomycin or gentamicin as part of treatment. Medications can be oral or injectable, and the doctor will monitor the patient for signs of brucellosis complications or adverse reactions to the antibiotics. It is difficult to pass brucellosis between people, but the patient will need to avoid individuals with compromised immune systems, and may need to be isolated if there is evidence of respiratory infection.
If the patient does not respond to initial brucellosis treatment, the doctor will adjust the medications. Some bacteria have antibiotic resistance and may not die off in response to the first round of combination therapy. The doctor may also consider the risks of endocarditis in the patient. Most brucellosis deaths are attributable to endocarditis, and the doctor wants to minimize the chance of developing this infection. If necessary, the doctor may recommend hospitalization for aggressive antibiotic therapy and monitoring.
Patients need to fully complete brucellosis treatment, even if they start to feel better. The tendency of the bacteria to incubate can pose a problem because patients may stop experiencing symptoms and feel healthy when they are still infected. At the end of treatment, the doctor will evaluate the patient and decide if the problem is resolved or if the patient needs an additional round of antibiotics. While long courses of antibiotics can cause discomfort because of symptoms like nausea and vomiting, doctors want to err on the side of caution with brucellosis treatment since the infection has a reputation for remaining dormant and reappearing when least expected.
