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P Geijo

Publications and source records attributed to P Geijo.

11 recordsLinked to original sources
PubMed2000

[Evaluation of 2 tuberculosis chemoprophylaxis regimens in patients infected with human immunodeficiency virus. The GECMEI Group].

OBJECTIVE: To assess the compliance, tolerance and efficacy of a short chemoprophylaxis regimen (IR) for tuberculosis using isoniazid (INH) plus rifampin (RIF) during 3 months versus a standard regimen (I) of isoniazid during 12 months in HIV positive patients. MATERIAL AND METHODS: Prospective, comparative, randomized and open clinical trial in four general hospitals and one prison hospital of Castilla-La Mancha. Prophylaxis was administered to PPD-positive patients and to anergic patients according to the CDC recommendations (1991). Patients were randomized in two treatment groups: regimen IR, isoniazid 300 mg daily and rifampin 600 mg daily; regimen I, isoniazid 300 mg during 12 months. RESULTS: 133 patients were included, 64 to regimen I and 69 to regimen IR. Regimen IR had a better tolerance with a 28% of adverse effects versus 55% in regimen I. Hepatotoxicity was more frequent in regimen I with a RR = 2.2 (CI 95% 1.23-4.01). Severe hepatotoxicity leading to treatment withdrawal was related to drug administration time and was more frequent in the 12 months regimen group. Short regimen showed a better compliance, without significant differences. Tuberculosis incidence rate was a 4.23 cases/100 persons--year for regimen I and 2.08 in regimen IR, with a relative risk for developing tuberculosis with regimen IR group of 0.51 (CI 95% 0.09-2.8) versus regimen I group, without statistical significance. Prison stay was associated to a significant risk for tuberculosis, regardless of both regimens (RR = 9.2 CI 95%, 1.06-80.2). CONCLUSIONS: In HIV-infected patients with PPD(+) or anergic, regimen with IR is at least as effective as regimen I for preventing the development of tuberculous disease, and has less adverse effects.

AIDS-Related Opportunistic Infections↗
PubMed1998

Multivariate model for predicting relapse in human brucellosis.

Demographic, clinical, and laboratory data from 200 consecutive patients with acute brucellosis were analysed with univariate and multivariate methods to identify correlates of relapse. A risk score for predicting relapse was then calculated by using Cox proportional hazard model. The independent predictors of relapse were temperature of 38.3 degrees C or higher, positive blood cultures at baseline, and the duration of symptoms before treatment <10 days. Stratification according to the risk score demonstrated that rates of relapse were significantly different between risk groups (P<0.0001). The low-risk group had a 4.5% probability (6 of 135) of relapse at 12 months. In contrast, relapse was present in 15 of 47 patients in the medium-risk group (P<0.0017); and in 12 of 18 patients in the high-risk group (P<0.0001). This study provides a rational basis for estimating the risk of relapse in patients with acute brucellosis, and may be helpful in deciding what subjects might benefit from extra attention.

Adult↗
PubMed1997

Treatment of human brucellosis with doxycycline and gentamicin.

The objective of the present prospective, noncomparative, multicenter study was assess the safety and efficacy of gentamicin and doxycycline therapy for human brucellosis. In the first part of the study, a cohort of 17 patients received 100 mg of doxycycline (or 50 mg/kg of body weight per day if the body weight was < 40 kg) orally every 12 h for 45 days (cohort 1). In the second part of the study a subsequent cohort of 35 patients was treated with doxycycline at the same dosage for 30 days (cohort 2). All patients were treated intramuscularly with gentamicin at 240 mg (or 5 mg/kg per day if the body weight was < 50 kg) once daily for the first 7 days. Both cohorts showed a favorable response during therapy, and there were no therapeutic failures. Relapse was noted in 1 (5.9%; 95% confidence interval [95% CI], 0.15 to 28.7%) of the 17 patients in cohort 1 and in 8 (22.9%; 95% CI, 10.4 to 40.1%) of the 35 patients in cohort 2. Nineteen patients (36.5%; 95% CI, 23.6 to 51.0%) had adverse effects, with no differences between cohorts, and no patients had a treatment-limiting adverse effect. The study indicates that the combination of doxycycline for 45 days and gentamicin for 7 days is an effective and well-tolerated therapy for human brucellosis. The relapse rates obtained with doxycycline treatment for 30 days appear to be higher than those obtained with doxycycline treatment for 45 days.

Adolescent↗
PubMed1996

Treatment of human brucellosis with netilmicin and doxycycline.

We conducted a prospective, noncomparative, multicenter study to assess the safety and efficacy of doxycycline and netilmicin in the treatment of human brucellosis. The study included 64 patients who had acute brucellosis without endocarditis or neurobrucellosis. The treatment schedule consisted of the administration of 100 mg of doxycycline (or 5 mg/[kg.d] if body weight < or = 40 kg) twice a day orally for 45 days, plus 300 mg of netilmicin (6 mg/[kg.d] if body weight < or = 50 kg) intramuscularly once daily for 7 days. Therapeutic failure was noted in 5 patients (7.7%; 95% confidence interval [CI], 2.5%-17.1%), of whom 2 had spondylitis, 1 had sacroiliitis, and 1 had a splenic abscess that required splenectomy. Relapse was noted in eight patients (12.5%; 95% CI, 5.6%-23.2%). When relapse was considered in combination with initial lack of efficacy, 13 patients (21.9%; 95% CI, 12.3%-33.9%) failed to respond to therapy. Fifteen patients (23%; 95% CI, 13.5%-35.2%) had adverse effects, and one patient (1.5%) had a treatment-limiting adverse effect. Combination therapy with netilmicin/doxycycline may be effective in treating acute brucellosis. However, prospective controlled trials must confirm these results.

Acute Disease↗
PubMed1995

Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. The GECMEI Group. Grupo de Estudio de Castilla-la Mancha de Enfermedades Infecciosas.

Brucellosis is a common zoonosis in many parts of the world; the best regimen for the treatment of brucellosis has not been clearly determined. We have carried out a multicenter, open, controlled trial in five general hospitals in Spain to compare the efficacy and safety of doxycycline and rifampin (DR) versus doxycycline and streptomycin (DS) for the treatment of human brucellosis. The study included 194 ambulatory or hospitalized patients with acute brucellosis, without endocarditis or neurobrucellosis. The diagnostic criterion was isolation of Brucella species from blood or other tissues (n = 120) or a standard tube agglutination titer of 1/160 or more for anti-Brucella antibodies with compatible clinical findings (n = 74). Patients were randomly assigned to receive either 100 mg of doxycycline twice daily plus rifampin, 900 mg/day, in a single morning dose for 45 days (DR group) or the same dose of doxycycline for 45 days plus streptomycin, 1 g/day, intramuscularly for 14 days (DS group). A lack of therapeutic efficacy developed in 8 of the 100 patients in the DR group (8%) and in 2 of the 94 patients in the DS group (2%)(P = 0.10). Relapses occurred in 16 of the 100 patients in the DR group (16%) but in only 5 of the 94 patients in the DS group (5.3%) (P = 0.02). When relapse was considered in combination with initial lack of efficacy, 26 patients in the DR group (24%) and 7 patients in the DS group (7.45%) failed to respond to therapy (P = 0.0016). In general, therapy was well tolerated and only four patients (4%) in the DR group and two (2%) in the DS group had episodes of adverse effects necessitating discontinuation of treatment (P> 0.2). We conclude that a doxycycline-and-rifampin regimen is less effective than the doxycycline-and-streptomycin regimen in patients with acute brucellosis.

Adolescent↗
PubMed1992

[Brucellar sacroiliitis. A detailed review with an analysis of treatment efficacy].

All patients diagnosed of brucellosis in 4 regional hospitals during a period of nine years were reviewed, in an attempt to evaluate the efficacy of different antimicrobic regimens and also the clinical features. Evolution and complications of brucellar sacroiliitis. Of a total of 548 patients, 12% had been diagnosed of sacroiliitis and, of theme, 49 had complete data available with efficacy of different treatments, the time elapsed until fever and pain ceased was evaluated, together with initial therapeutic failures, relapses and length of hospital stay. Brucellar sacroiliitis is the most frequent osteoarthral complication of Brucella sp. in our setting. Keeping an stable incidence. It is predominant among young male (82%) population (mean age 25 +/- 12 years). The illness evolution is acute and less frequently subacute with a evolution mean-time before referral of 38 +/- 44 days (minimum 4 days, maximum 180 days). Fever (81%) and pain on gluteus and low lumbar localizations (100%) are the more frequent clinical features. Time elapsed until pain ceased was longer with doxycycline plus rifampicin (68 +/- 86) than with doxycycline plus streptomycin (28 +/- 43) (less than 0.05) and length of hospital stay was also longer with said treatment (p less than 0.05). There were no differences concerning time frame until fever ceased, initial therapy failures and relapses. Sequelae are infrequent and consist in persistency of pain. In resume response to treatment with usual regimens, doxycycline plus streptomycin of doxycycline rifampicin is good, being however time elapsed until pain ceases of mean length in hospital stay shorter in the group receiving doxycycline plus streptomycin. Control studies to confirm these data are need.

Age Factors↗
PubMed1991

[A comparative therapeutic and multicenter trial of rifampicin and doxycycline versus streptomycin and doxycycline in human brucellosis].

BACKGROUND: Comparison and evaluation of the efficacy and safety of two treatment schedules in human brucellosis. METHODS: A comparative, randomized, multicentric, open study of 45 days doxycycline plus rifampin in the initial 21 days (group A) versus 45 doxycycline plus streptomycin in the initial 14 days (group B). 42 were included in each group. The diagnosis of brucellosis was based on blood culture or consistent clinical findings and a Wright's serum agglutination titer of 1/160 or greater. Clinical and laboratory monitoring was carried out, including blood cultures on the days 7 and 48 and after 3, 6, and 12 months. RESULTS: 38 patients in each group were evaluable at the end of treatment. 3 group A patients and 1 group B patient had initial therapeutic failure. 31 group A patients and 35 group B patients could be followed up during 6 months or more (mean follow up of 10.5 and 11.5 months, respectively). 9 relapses (29%) developed in group A and 2 (6%) in group B (p less than 0.05). 22 patients of the 34 finally evaluated in group A (65%) were considered as cured, versus 33 of the 36 in group B (92%) (p less than 0.01). Side effects not requiring withdrawal of the treatment developed in 12 patients, without differences between the two groups. CONCLUSIONS: In the therapy of human brucellosis, the association of doxycycline (45 days) and rifampin (21 days) is less effective than the classical association of doxycycline and streptomycin.

Adolescent↗
PubMedDate not supplied

[Comparative study of the Brucellacapt test versus the Coombs test for Brucella].

BACKGROUND: To compare the results obtained by Brucella Coombs' test with those obtained by Brucellacapt. MATERIAL AND METHODS: 145 serum samples from 112 patients with brucellosis or with brucellar infection suspected on clinical grounds and a history of occupational exposure were analyzed. All serum samples were tested for Rose Bengal, agglutinations whenever Rose Bengal was positive, Brucella Coombs' test and Brucellacapt. RESULTS: There was a direct correlation between both methods (p < 0.01). Negative serum samples and most serum samples with titers between 1/40 and 1/2,560 as tested by Brucella Coombs' test showed similar results into a range of one to two dilutions by Brucellacapt. However, serum samples with titres between 1/5,120 and 1/40,960 by Brucella Combs' test yielded also higher titres by Brucellacapt and for this reason we were unable to define a titre. CONCLUSIONS: Brucellacapt is a rapid assay to exclude infection and yield results comparable to Brucella Coombs' test in range 1/40 to 1/2,560. Significantly higher and more rapid titres were obtained in acute brucellosis by Brucellacapt as compared with those obtained by Brucella Coombs' test. Titre's evolutions by Brucellacapt is similar to Brucella Coombs' test. Unfortunately it was difficult the titres definition of Brucellacapt at high titres.

Brucellosis↗