The Clinical Course of Brucellosis, Taking into Account the Phenotype of Acetylation in Patients

This work aimed to study the relationship of the acetylator phenotype with the features of the clinical course of brucellosis in patients to develop prognostic criteria for the development of complications and indications for the use of antibiotics depending on the degree of N acetyltransferase activity. Materials and methods. The study included 178 patients with various clinical forms of brucellosis. The acetylation phenotype was determined in urine by the method of A.M. Timofeeva modified by G.A. Ponomarev. Results. The results obtained showed that brucellosis in SA has a longer duration with destructive and necrotic lesions of organs such as the myocardium, liver, brain, and joints. Since the process of SA is sluggish, intermediate products of inflammation accumulate in the body, and high endogenous intoxication develops. The transition of an acute process to a chronic one increases. The conducted antibiotic therapy has a positive effect since a high concentration of the antibiotic accumulates in the body, but the toxic effect of the drug on the liver increases. For patients with FA the process proceeds quickly, due to this, endogenous intoxication in patients is low, the antibiotic therapy carried out is temporary, since the antibiotic is released from the body faster and the expected effect is not observed. Due to this, in 24.5% of adults with FA, the acute process becomes chronic. Conclusions: obligatory determination of the type of acetylation phenotype: in cases of detection of a slow type of acetylation, the appointment of combined antibiotic therapy should be controlled depending on the value of ABL to the TA of the joints with cancellation or continuation of treatment and add hepatoprotection to prevent hepatotoxic effect and detoxification therapy; in cases of detection of a rapid type of acetylation, the appointment of a longer course of combined antibiotic therapy, depending on the value of ABL to TA of the joints, cancel or continue treatment.