Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran.
Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Vector Borne Zoonotic Dis. 2024 Jan;24(1):1-9. doi: 10.1089/vbz.2023.0063. Epub 2023 Oct 20.
Brucellosis impact both animals and humans worldwide. However, using antibiotics for brucellosis remains controversial despite decades of research. Relapse can complicate treatment in this area. Since the mid-1980s, microbiologists, and physicians have studied fluoroquinolones' use for treating human brucellosis. The principal advantages of fluoroquinolones are their intracellular antimicrobial activity, low nephrotoxicity, good pharmacokinetics, and the lack of drug-level monitoring. Fluoroquinolones inhibit disease recurrence. and clinical data were used to study the prevalence of and fluoroquinolone-resistant isolates. The PubMed, Scopus, Embase, and Web of Science databases were carefully searched until August 6, 2022, for relevant papers. The number of resistant isolates and sample size were used to estimate the proportion of resistant isolates, fitting a model with random effects, and DerSimonian-Laird estimated heterogeneity. Furthermore, meta-regression and subgroup analyses were used to assess the moderators to identify the sources of heterogeneity. Meta-analysis was performed using R software. Forty-seven studies evaluated fluoroquinolone resistance in spp. Isolates. Fluoroquinolones have shown high efficacy against spp. The resistance rates to ofloxacin, sparfloxacin, fleroxacin, pefloxacin, and lomefloxacin were 2%, 1.6%, and 4.6%, respectively. Clinical tests demonstrated that fluoroquinolones can eradicate spp. Owing to first-line medication resistance, recurrence, and toxicity, it is essential to standardize the antimicrobial susceptibility test method for a more precise screening of resistance status. Fluoroquinolones are less resistant to fluoroquinolone-based treatments in modern clinical practice as alternatives to standard therapy for patients with brucellosis relapse after treatment with another regimen and in patients who have developed toxicity from older agents.
布鲁氏菌病对全球的动物和人类都有影响。然而，尽管已经进行了几十年的研究，抗生素治疗布鲁氏菌病仍然存在争议。在这一领域，复发会使治疗复杂化。自 20 世纪 80 年代中期以来，微生物学家和医生一直在研究氟喹诺酮类药物治疗人类布鲁氏菌病的用途。氟喹诺酮类药物的主要优点是其细胞内抗菌活性、低肾毒性、良好的药代动力学和无需药物水平监测。氟喹诺酮类药物抑制疾病复发。临床数据用于研究 和 氟喹诺酮耐药分离株的流行率。仔细搜索了 PubMed、Scopus、Embase 和 Web of Science 数据库，以获取相关论文，直到 2022 年 8 月 6 日。使用耐药分离株的数量和样本量来估计耐药分离株的比例，拟合具有随机效应的模型，并使用 DerSimonian-Laird 估计异质性。此外，还进行了荟萃回归和亚组分析，以评估调节因素，以确定异质性的来源。使用 R 软件进行荟萃分析。47 项研究评估了 spp. 分离株的氟喹诺酮耐药性。氟喹诺酮类药物对 spp. 显示出很高的疗效。氧氟沙星、司帕沙星、氟罗沙星、培氟沙星和洛美沙星的耐药率分别为 2%、1.6%和 4.6%。临床研究表明，氟喹诺酮类药物可以消除 spp. 由于一线药物耐药性、复发和毒性，规范 抗菌药物敏感性试验方法对于更准确地筛选耐药状态至关重要。在现代临床实践中，由于替代方案对氟喹诺酮类药物的耐药性，以及在使用另一种方案治疗后复发的布鲁氏菌病患者和因使用旧药物而产生毒性的患者中，氟喹诺酮类药物作为标准治疗的替代方案，对氟喹诺酮类药物的耐药性较低。
