Brucella species

Background:

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Gram-Negative Cocci & Coccobacilli
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>Aggregatibacter aphrophilus (formally known as Haemophilus aphrophilus)
>Bordetella pertussis (Causative agent of pertussis or whooping cough. )
>Brucella species:

     1] Brucella abortus (cattle)
     2] Brucella canis (dogs)
     3] Brucella melitensis (goat)
     4] Brucella suis
>Eikenella corrodens
>Haemophilus species:
     1] Haemophilus influenzae
     2] Haemophilus ducreyi
     3] Haemophilus avium
>Moraxella catarrhalis (formerly known as Branhamella catarrhalis)
>Neisseria species: (frequently colonize mucosal surfaces.)
     1] Neisseria gonorrhoeae
     2] Neisseria meningitidis
>Pasteurella multocida

Brucella species:

non-motile, non-encapsulated coccobacilli, which function as facultative intracellular parasites.
Cause of brucellosis, which is transmitted by ingesting contaminated food (such as unpasteurized milk products), direct contact with an infected animal, or inhalation of aerosols.
Source: https://en.wikipedia.org/wiki/Brucella

Therapy:

Important considerations: The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions. Generally, the most common agents/regimens are listed first. Listed dosages may need to be adjusted for renal dysfunction.

Adults and children >8 years old:

Primary: Doxycycline 100mg orally or IV twice daily x 6 weeks PLUS [ Streptomycin 15 mg/kg (or 1 gram) IM once daily x 14 days OR Gentamicin 5 mg/kg/day IV (Adjust frequency based on estimated clearance) x 7 days]
Secondary:
- Doxycycline 100mg orally or IV twice daily PLUS Rifampin 600-900mg orally once daily x 6 weeks. OR
- Ciprofloxacin 500 mg orally twice daily PLUS [ Doxycycline 100mg orally or IV twice daily OR Rifampin 600-900mg orally once daily] x 6 weeks
Review specialized reference(s) for neurological involvement and treatment of pregnant patients or children.
Other: TMP-SMX (Bactrim) IV/PO PLUS [ Gentamicin IV OR Rifampin oral].

Streptomycin comments: Streptomycin is usually administered daily as a single intramuscular injection. For concomitant use with other agents to which the infecting organism is also sensitive: Streptomycin is considered a secondline agent for the treatment of gram-negative bacillary bactermia, meningitis, and pneumonia; brucellosis; granuloma inguinale; chancroid, and urinary tract infection.
For adults: 1 to 2 grams in divided doses every six to twelve hours for moderate to severe infections. Doses should generally not exceed 2 grams per day.
For children: 20 to 40 mg/kg/day (8 to 20 mg/lb/day) in divided doses every 6 to 12 hours. (Particular care should be taken to avoid excessive dosage in children).