Page 83 - MI-2-1

Microbes & Immunity Childhood brucellosis in Saudi Arabia

prescribed to patients older than 9 years (except for one Acknowledgments
4-year-old who was given doxycycline). Recent evidence
suggests that doxycycline can be safely given to children We thank the IT department and the immunology
and pregnant women. A thorough retrospective analysis laboratory of King Abdulaziz University Hospital
26
of 1843 newborns with prenatal doxycycline exposure for providing the lists of patients. We also thank the
revealed no greater risk of birth defects or teratogenic risks microbiology and immunology laboratory for their
when compared to those who were not exposed. These assistance with the methods section.
27
findings suggest that the advantages of doxycycline use Funding
in young patients may outweigh the possible risks when
treating specific diseases without effective alternatives or None.
when doxycycline is considered the treatment of choice, as
in the case of brucellosis. 28 Conflict of interest
Ciprofloxacin may be beneficial for brucellosis in Abrar K. Thabit is an Editorial Board Member of this
cases of drug resistance when used in combination with journal but was not in any way involved in the editorial
rifampin. 29,30 The patient who had neurobrucellosis was and peer-review process conducted for this paper, directly
treated with a combination of doxycycline, trimethoprim/ or indirectly. Separately, other authors declared that they
sulfamethoxazole, and ceftriaxone. Per a previous have no known competing financial interests or personal
report, doxycycline and trimethoprim/sulfamethoxazole relationships that could have influenced the work reported
have been found to be effective in neurobrucellosis. in this paper.
31
Furthermore, third-generation cephalosporins with the Author contributions
ability to diffuse through the central nervous system,
such as ceftriaxone, have shown good in vitro activity Conceptualization: Abrar K. Thabit
against isolates of B. melitensis. The Saudi guidelines Formal analysis: Abrar K. Thabit, Manar O. Lashkar
32
recommend a regimen of doxycycline, trimethoprim/ Investigation: Renad S. Nahhas, Zain Y. Nemer, Zahra I.
sulfamethoxazole, and rifampin to treat neurobrucellosis. Askar, Walaa H. Alzahrani
They also discussed the advantages of using ceftriaxone Writing-original draft: Renad S. Nahhas, Zain Y. Nemer,
in the initial therapy of neurobrucellosis in children older Zahra I. Askar, Walaa H. Alzahrani, Sarah O. Alreeshi,
than 8 years. 7 Manar O. Lashkar
In our study, even though a clinical cure was achieved, Writing-review & editing: Abrar K. Thabit, Manar O.
the patient’s antibody titers persisted after treatment Lashkar.
was completed. The results of an earlier retrospective Ethics approval and consent to participate
investigation that found that Brucella serology did not
correlate with clinical outcomes at the end-of-treatment Ethical approval was obtained from the Research
follow-up provide an explanation for this. Consequently, Committee of the Unit of Biomedical Ethics, Faculty of
rather than depending exclusively on serological results Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
during follow-up, clinicians should take into account the (reference no. 128-18), who waived the need for informed
full clinical picture of the brucellosis patient and evaluate consent.
the attainment of a clinical cure based on the disappearance
of baseline signs and symptoms. 20 Consent for publication
This study has a few limitations. As a retrospective As this was a retrospective study (old data of patients who
study, some data were unavailable. It was also conducted in have been discharged from the hospital), such consent was
a single center and included a small sample size; thus, the not obtained and could not be obtained given the nature
results might not be generalizable. of the study.
5. Conclusion Availability of data

Our study described the characteristics of children Data are available from the corresponding author upon
diagnosed with brucellosis in an academic hospital, request.
highlighting typical signs and symptoms of fever, arthralgia, Further disclosure
and elevated liver enzymes. We emphasize that using a
combination of at least two antibiotics effective against The study abstract was published in the abstract book
Brucella spp. is important for ensuring clinical success. of the European Congress of Clinical Microbiology

Volume 2 Issue 1 (2025) 75 doi: 10.36922/mi.4634