Narrative review suggests phytochemicals and phages may augment conventional antibiotics for brucellosisNew plant-based and phage options might help treat stubborn brucellosis infections in people and animals

Brucellosis, a zoonotic disease, triggers severe inflammation and reproductive complications in both humans and animals. The standard treatment protocol relies on prolonged antibiotic courses, often combining streptomycin and doxycycline, or gentamicin and doxycycline, for a duration of six to eight weeks. However, concerns have arisen regarding the efficacy, with a notable 15% failure rate and frequent relapses. The lack of suitable vaccines and the rise of antimicrobial resistance in Brucella spp., due to prolonged antibiotic use further complicate the issue. This review underscores the pressing issue of antibiotic resistance, prompting an exploration of alternative treatment avenues. Phytochemicals like polyphenols and terpenoid rich essential oils have been reported to possess strong anti-Brucellar activity and function by disrupting cell wall and membrane functions, prevent binding to host cells and internalization and inhibit DNA replication and transcription and enzyme synthesis. Similarly, bacteriophages, have demonstrated promise as diagnostic, therapeutic and biocontrol agents in Brucellosis management. The efficacy of bacteriophage mediated strategies can be enhanced by site specific delivery through nano-encapsulation techniques while engineered phages can be used for diagnosis and modulate immune response in host. These alternative therapies have even been found to stimulate innate immunity in host. However, the precise mechanisms through which these treatments operate remain elusive, warranting further investigation. In conclusion, this paper advocates for the integration of novel plant-based therapy as adjuvant treatment option for both human and livestock brucellosis, while phage therapy as complementary strategy to augment the conventional treatments in livestock brucellosis. These non-antibiotic alternatives aim to improve treatment efficacy, reduce the required duration of conventional antibiotic regimens, and minimize economic losses in agriculture. The future of brucellosis management may lie in a multi-faceted approach that combines antibiotics with innovative, natural alternatives.