Re-assessment of Clinical Effect of Drug Compatibility and Course of Treatment to the Brucellar Spondylitis

OBJECTIVE To evaluate the drug treatment programs of brucellar spondylitis and to provide scientific evidence for the best drug choice and therapeutic effect. METHODS 200 cases from January of 2006 to July of 2011 diagnosed as brucellar spondylitis and consistent with the criterion were divided into five groups randomly, accepting different courses of treatment therapy and control study of five different kinds of drugs and five different kinds of compatibility methods voluntary. Therapeutic efficacy was evaluated by comparison of clinical effect in different course of treatment of each group, comparison of the group with and without deoxycycline and comparison among groups. Bacterial culture in 200 cases and susceptibility test was performed. Aspiration-needle biopsy in 157 cases was performed. RESULTS The cure rate and effective rate of the first course of treatment were significantly different with those of the second in five groups(P<0.05) while by comparing the cure rate and effective rate of the third course with those of the second in the first, second and third group, the difference had no significance(P>0.05), which indicated that the third course of treatment cannot improve the cure rate and effective rate, thus two courses of treatment was appropriate. By comparing the cure rate and effective rate in groups with deoxycycline with those without deoxycycline, the difference had significance(P<0.05), which indicated that the effect of groups with deoxycycline was better than that with no deoxycycline treatment. After two courses of treatment, the therapeutic effect between two different groups was significantly different(P<0.05), except the difference between the second and the third group (P>0.05), which indicated that the first group had the most obvious effect. In this experiment there were only 43 cases with positive bacterial culture, which were sensitive to deoxycycline, rifampicin, SMZ/TMP, Levofloxacin and phytomycin, and there were 157 cases consistent with pathologic manifestation of brucellar spondylitis by aspiration-needle biopsy. CONCLUSION Deoxycycline, rifampicin and SMZ/TMP should be chosen as the chief antibiotics for drug therapy of brucellar spondylitis and using the drugs for two courses of treatment is an appropriate method for the therapy and prevention of recurrence of brucellar spondylitis.