Comparison between antibiotic therapy of Brucellosis with and without vitamin A


1 Student Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Infectious Disease, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student Research Center, Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Brucellosis is one of the endemic diseases in our country and it can be in the types of acute, sub-acute or chronic. It estimates that about 20% of Brucellosis may change from acute to chronic. Because cell mediated immunity (CMI) is the main defense of body against Brucella species, it seems that some degree of Immunologic disorders existed in the patients with chronic form of diseases and some supplements such as Vitamin A (Vit A) as an immunomodulator can stimulate CMI and may decrease the rate of chronicity.
Materials and Methods: In a single-blind randomized clinical trial 120 patients with the clinical and serological diagnosed Brucellosis were randomized. A total of 60 patients received streptomycin and Doxycycline as standard therapy for 6 weeks and others in addition to this Regimen received Vit A for about 4 weeks.
Results: In the case group, only 1 case (1.6%) relapsed and in the control group 8 (13.5%) with significant difference (P < 0.005) between two groups. Morbidity of disease was different between two groups.
Conclusion: Vit A therapy in the patients with Brucellosis with may reduce the disease morbidity and rate of chronicity.


Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005;352:2325-36.  Back to cited text no. 1
Kozukeev TB, Ajeilat S, Maes E, Favorov M, Centers for Disease Control and Prevention (CDC). Risk factors for brucellosis - Leylek and Kadamjay districts, Batken Oblast, Kyrgyzstan, January-November, 2003. MMWR Morb Mortal Wkly Rep 2006;55:31-4.  Back to cited text no. 2
Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis 2006;6:91-9.  Back to cited text no. 3
Chang MH, Glynn MK, Groseclose SL. Endemic, notifiable bioterrorism-related diseases, United States, 1992-1999. Emerg Infect Dis 2003;9:556-64.  Back to cited text no. 4
Yagupsky P, Baron EJ. Laboratory exposures to brucellae and implications for bioterrorism. Emerg Infect Dis 2005;11:1180-5.  Back to cited text no. 5
Centers for Disease Control and Prevention (CDC). Suspected brucellosis case prompts investigation of possible bioterrorism-related activity - New Hampshire and Massachusetts, 1999. MMWR Morb Mortal Wkly Rep 2000;49:509-12.  Back to cited text no. 6
Spink WW, Farreras P, Pedro-Pons A. What is chronic brucellosis? Ann Intern Med 1951;35:258-74.  Back to cited text no. 7
Yingst S, Hoover DL. T cell immunity to brucellosis. Crit Rev Microbiol 2003;29:313-31.  Back to cited text no. 8
Kurmanova KB, Ishchanova RZh, Sakhisheva SSh, Studentsova VK, Tsirel'son LE, Alshinbaeva GU. Increasing the effectiveness of antibiotic therapy by correcting immunologic disorders with vitamin A in patients with brucellosis. Antibiot Khimioter 1990;35:35-8.  Back to cited text no. 9
Dizer U, Hayat L, Beker CM, Görenek L, Ozgüven V, Pahsa A. The effect of the doxycycline-rifampicin and levamisole combination on lymphocyte subgroups and functions of phagocytic cells in patients with chronic brucellosis. Chemotherapy 2005;51:27-31.  Back to cited text no. 10
Chandra PK. Nutritent and Immunoregulation. J Nutr. 1992;122 Suppl 3:754-7.  Back to cited text no. 11
Salehi H. Comparing standard treatment of brucellosis with and without Vitaamin A. J Isfahan Med Sch (I.U.M.S) 2003;20:56-8.  Back to cited text no. 12
Michael J.Cobel, Nicholas J.Beeching. Brucellosis. Harrison's Principle's Internal Medicine. 18 th ed., Vol. 1. Chapter 157. 2012. p. 1299-300.  Back to cited text no. 13
Colmenero JD, Reguera JM, Martos F, Sánchez-De-Mora D, Delgado M, Causse M, et al. Complications associated with Brucella melitensis infection: A study of 530 cases. Medicine (Baltimore) 1996;75:195-211.  Back to cited text no. 14
Solera J, Geijo P, Largo J, Rodriguez-Zapata M, Gijón J, Martinez-Alfaro E, et al. A randomized, double-blind study to assess the optimal duration of doxycycline treatment for human brucellosis. Clin Infect Dis 2004;39:1776-82.  Back to cited text no. 15
Hasanjani Roushan MR, Mohraz M, Hajiahmadi M, Ramzani A, Valayati AA. Efficacy of gentamicin plus doxycycline versus streptomycin plus doxycycline in the treatment of brucellosis in humans. Clin Infect Dis 2006;42:1075-80.  Back to cited text no. 16
Lulu AR, Araj GF, Khateeb MI, Mustafa MY, Yusuf AR, Fenech FF. Human brucellosis in Kuwait: A prospective study of 400 cases. Q J Med 1988;66:39-54.  Back to cited text no. 17