Drug Interactions Lead to Recurrent Seizures in Brucellosis: A Case Report

Brucellosis is a prevalent zoonotic infectious disease that poses a significant public health concern. The economic burden of human brucellosis includes hospitalization costs, pharmacological treatment, out-of-pocket expenses, and income loss due to missed work during illness. This case report describes recurrent seizures resulting from drug interactions in a patient undergoing treatment for brucellosis. Although rifampicin-based regimens are the first-line treatment for brucellosis, rifampicin is a potent inducer of various drug-metabolizing enzymes and can interact with numerous medications, including antiepileptic drugs. Alternative anti-Brucella agents may be considered when drug interactions are of concern. The choice of antiepileptic therapy should aim to minimize potential interactions with rifampicin. If such interactions are unavoidable, co-administration should be closely managed using therapeutic drug monitoring to prevent subtherapeutic dosing, seizure recurrence, or compromised brucellosis treatment efficacy. In this case, rifampicin was replaced with an alternative anti-Brucella agent to minimize interaction risks, and antiepileptic drug dosages were optimized using therapeutic drug monitoring to achieve seizure control. Patient education on medication adherence was also reinforced to support treatment outcomes.