Acute brucellosis

An acute bacterial infection caused by Brucella species, usually acquired through unpasteurized dairy or contact with infected animals. It presents with undulant fever, sweating, joint pain, and fatigue.

ICD-10 A231 drug

Also known as: Acute uncomplicated brucellosis, Malta fever, Undulant fever

Drugs used for this condition

AGentamicinFirst line · Aminoglycoside antibioticIn acute uncomplicated brucellosis, gentamicin belongs to the first-line doxycycline + gentamicin combination rather than acting as an optional add-on. In a 2024 network meta-analysis of randomized controlled trials (PLoS Neglected Tropical Diseases), doxycycline + gentamicin ranked first for efficacy and safety (SUCRA 0.94), ahead of the standard doxycycline + rifampicin. Earlier meta-analyses of randomized controlled trials (BMJ 2008, PLoS One 2012) showed that aminoglycoside-containing regimens produce fewer relapses and treatment failures. Gentamicin strengthens the bactericidal activity of doxycycline against intracellular Brucella.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit