Clinical Research Directory

All-Oral Fluoroquinolone-Based Triple Therapies for Adults With Imaging-Confirmed Osteoarticular Brucellosis

Brucellosis is a globally distributed zoonosis with persistent clinical management challenges. The World Health Organization (WHO)-recommended doxycycline-rifampin (DOX-RIF) dual regimen may drive rifampin-associated antimicrobial resistance in brucellosis-endemic regions. Patients with osteoarticular brucellosis, the most common focal complication of brucellosis, often require long-term intravenous ceftriaxone triple therapy. This parenteral regimen leads to poor treatment adherence, frequent hospital visits and heavy outpatient burdens. Fluoroquinolones (levofloxacin \[LVX\], moxifloxacin \[MXF\]) exert excellent anti-Brucella activity and superior bone-joint penetration. However, high-quality multicenter prospective data comparing rifampin-sparing LVX-DOX / MXF-DOX regimens against the standard RIF-DOX regimen remain scarce. Existing comparative studies are limited to small single-center retrospective cohorts or trials combining rifampin with fluoroquinolones rather than rifampin-free all-oral triple regimens.