The Antibiotic Susceptibility of Brucella spp. Isolated from Human Samples: A Systematic Review and Meta-Analysis

Background and Aim: Effective brucellosis treatment necessitates antibiotics that can penetrate macrophages. This study systematic review and meta-analysis aimed at assessing the antibiotic susceptibility profile of Brucella spp. isolated from humans, addressing this critical gap in understanding Brucella infections and their treatment. Materials and Methods: Two authors conducted a systematic search across PubMed, Web of Science, and Scopus, with no time restrictions, encompassing English studies. Data extraction employed a standardized sheet, with two independent authors, and disagreements were resolved by a third. The data sheet included study characteristics and susceptibility/resistance information for various antibiotics. Statistical analysis involved random effects models, Mantel-Haenszel methods, I2 tests, z-tests, and funnel plots using R and RStudio. Results: Based on the pooled susceptibility ratios, among the 630 samples of Brucella spp., 98% (95% CI: 85% - 100%) were susceptible to trimethoprim. Among the 1255 samples of Brucella spp., 82% (95% CI: 54% - 95%) were susceptible to rifampicin. Among the 1344 samples of Brucella spp., 100% (95% CI: 78% - 100%) were susceptible to doxycycline. Among the 942 samples of Brucella spp., 100% (95% CI: 85% - 100%) were susceptible to tetracycline. Among the 893 samples of Brucella spp., 100% (95% CI: 82% - 100%) were susceptible to ciprofloxacin. Among the 906 samples of Brucella spp., 97% (95% CI: 96% - 98%) were susceptible to gentamicin. Conclusion: Based on our results, trimethoprim, doxycycline, tetracycline, ciprofloxacin, and gentamicin were effective, but rifampicin had lower susceptibility. This informs antibiotic selection for Brucella infections, underscoring its importance in managing the disease.