Comparison between compound sulfamethoxazole and ceftriaxone on therapeutic effects and influence on cerebrospi-nal fluid inflammatory factors in patients with neurogenic brucellosis complicated with fever
Objective To explore the impact of ceftriaxone and compound sulfamethoxazole on the therapeutic out-comes and levels of inflammatory markers in the cerebrospinal fluid of patients suffering from neuroborreliosis accompanied by fever.Methods From August 2021 to December 2023,88 patients diagnosed with neuroborreliosis were admitted to our hospital and divided randomly into two groups:the standard treatment group(n=44)and the combined treatment group(n=44).Both groups received a treatment regimen consisting of rifampicin and doxycycline.Additionally,ceftriaxone sodium was administered to the standard treatment group,while the combined treatment group received compound sulfamethox-azole.Treatment was carried out continuously for a duration of 6 weeks.A comparative analysis was conducted on the de-mographic characteristics of the patients in the two groups,changes in abnormal symptoms and signs,as well as variations in blood routine and biochemical indexes and cerebrospinal fluid inflammatory markers before and after treatment.Further-more,the study also assessed the treatment response rates and the occurrence of adverse events in both groups.Results The overall treatment efficacy in the combined therapy group reached 97.73％ ,surpassing significantly the efficacy observed in the standard treatment group(84.09％ ,x2/P=4.950/0.026).Post-treatment,the mean values of erythrocyte sedimentation rate(ESR),serum C reactive protein(CRP),and procalcitonin(PCT)in the combined therapy group exhibited a significant de-cline compared to baseline levels and standard treatment group(t/P=5.342/＜0.001,5.654/＜0.001,5.543/＜0.001).Further-more,the average concentrations of interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),and interferon gamma(IFN-γ)in the cerebrospinal fluid of the combined therapy group were markedly lower post-treatment than those in the pre-treatment and standard treatment groups(t/P=4273/＜0.001,3.140/0.002,2.650/0.010).Moreover,there was no discernible difference in the total incidence of adverse reactions between the two groups(34.09％ vs.22.73％ ,P＞0.05).Conclusion The use of a combination of three drugs that include sulfamethoxazole has shown to be beneficial in alleviating the abnormal symptoms and signs in patients suffering from neuroborreliosis and fever.Furthermore,this regimen has demonstrated efficacy in re-ducing the levels of inflammatory factors in the cerebrospinal fluid,thereby enhancing the overall clinical outcomes.Com-pared to traditional treatments,the triple therapy has a lower incidence of adverse reactions,making it a safe and effective option with promising prospects for clinical applications.
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