Melioidosis: One Drug or Two for the Oral Phase of Treatment?

For the oral treatment phase for melioidosis, TMP-SMX plus placebo was not inferior to TMP-SMX plus doxycycline and was safer and better tolerated.

Melioidosis, caused by the gram-negative soil- and water-dwelling Burkholderia pseudomallei, can be acute, subacute, chronic, or latent. Treatment typically involves parenteral ceftazidime or a carbapenem followed by long-course oral antibiotics. To compare the efficacy and safety of two oral regimens, investigators undertook a multicenter, double-blind trial in Thailand, where the disease is endemic.

Adults with culture-confirmed melioidosis who had completed (or did not need) parenteral therapy were randomized to receive trimethoprim-sulfamethoxazole (TMP-SMX) plus either doxycycline or placebo for 20 weeks. All drugs were provided by the manufacturer. Follow-up lasted ≥1 year.

Among 626 enrollees, culture-confirmed recurrent melioidosis oc…

Reviewing Author

Mary E. Wilson, MD

Disclosures

Consultant/Advisory BoardOneHealthTrust (formerly Center for Disease Dynamics, Economics, and Policy); Global Health Institute, University of Wisconsin

RoyaltiesUpToDate

Editorial BoardsJournal of Travel Medicine

Mary E. Wilson, MD

Disclosures

Consultant/Advisory BoardOneHealthTrust (formerly Center for Disease Dynamics, Economics, and Policy); Global Health Institute, University of Wisconsin

RoyaltiesUpToDate

Editorial BoardsJournal of Travel Medicine

Melioidosis: One Drug or Two for the Oral Phase of Treatment?

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Reviewing Author