COCUK ENFEKSIYON DERGISI, cilt.17, ss.91-98, 2023 (ESCI)
Objective: Brucellosis is a permanent health problem in many developing countries globally, and the search for simple and effective treatments
is of high importance. Gentamicin, used in the treatment of brucellosis,
has effects on calcium homeostasis as an extracellular calcium-sensing receptor (CaSR) agonist. In this study, it was aimed to compare
post-treatment relapse rates between patients who were administered
with intravenous gentamicin for 14 days and patients who were administered oral antibiotics in order to investigate the effects of gentamicin
on calcium homeostasis.
Material and Methods: Retrospectively, a positive Rose Bengal test result in patients younger than 18 years, Wright agglutination titer ≥1/160
or Brucella spp. patients diagnosed with brucellosis in any of the culture
samples were scanned through their files. Patients receiving oral therapy (Group 1/Regimen 1) and patients receiving intravenous therapy
(Group 2/Regimen 2), complete blood count (hemogram); erythrocyte
sedimentation rate; spot urinary electrolyte levels; and serum urea, creatinine, aspartate aminotransferase, alanine aminotransferase, calcium,
phosphorus, magnesium, alkaline phosphatase, PTH, 25 hydroxy vitamin
D3, albumin, total protein and electrolyte levels were evaluated.
Results: There was a statistically significance variability in serum potassium, calcium, and phosphorus levels, parathyroid hormone, 25-dihydroxyvitamin D3, and alkaline phosphatase in the patients who were
administered with gentamicin. In seven of the 21 patients (33.3%) who
were administered with Regimen 1, relapse/treatment failure was observed within the first six months after the treatment. There was no relapse observed in any of the 61 patients who were administered with
Regimen 2.Conclusion: Fourteen days of intravenous gentamicin with 45 days of
doxycycline/trimethoprim-sulphamethoxazole treatment can be administered in order to eliminate relapse risk in the treatment of childhood
brucellosis. Gentamicin, used as a CaSR agonist, may cause temporary
changes in calcium homeostasis.