doxycycline + rifampicin + moxifloxacin

Doxycycline + rifampicin + moxifloxacin is a triple oral antibiotic combination therapy being investigated for the treatment of brucellosis, particularly the osteoarticular form. This regimen combines three distinct mechanisms of action to combat *Brucella* species: doxycycline inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit; rifampicin inhibits DNA-dependent RNA polymerase, preventing transcription; and moxifloxacin, a fourth-generation fluoroquinolone, inhibits DNA gyrase and topoisomerase IV to disrupt DNA replication. The combination is specifically designed to improve bone and joint penetration and provide a fully oral alternative to traditional regimens that require prolonged intravenous administration of drugs like ceftriaxone. It is currently being evaluated in the multicenter BRUCE study to determine its efficacy and safety compared to standard-of-care dual therapies, with the additional goal of reducing the selection pressure for rifampicin resistance.