Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

An open randomized comparison of the oral 'conventional' regimen (combination of chloramphenicol, cotrimoxazole and doxycycline) and co-amoxiclav for the maintenance treatment of melioidosis was conducted in Ubon Ratchatani, north-eastern Thailand, between 1989 and 1992. The total antibiotic treatment duration was 20 weeks. Of 101 patients followed, 10 (10%; 95% confidence interval [CI] 4.9-17.5%) subsequently relapsed: 2 of 52 patients (4%) in the oral 'conventional' group, and 8 of 49 patients (16%) receiving oral co-amoxiclav. This compares with a relapse rate of 23% in our previous study of 8 weeks' total therapy. Only 50% of patients complied with the 20 weeks' treatment regimen and poor compliance proved the most significant risk factor for subsequent relapse (relative risk [RR] 4.9, 95% CI 1.2-20.3). Neither the presence of known underlying disease nor choice of initial parenteral treatment was significantly associated with a higher risk of relapse. Co-amoxiclav is safer and better tolerated, but may be less effective (RR of relapse 0.4, 95% CI 0.2-1.2) than the oral 'conventional' regimen. The minimum duration of total treatment with either regimen should be 12-20 weeks, depending on clinical progress.

Original publication

DOI

10.1016/0035-9203(95)90104-3

Type

Journal article

Journal

Trans R Soc Trop Med Hyg

Publication Date

09/1995

Volume

89

Pages

546 - 549

Keywords

Adolescent, Adult, Aged, Aged, 80 and over, Amoxicillin, Amoxicillin-Potassium Clavulanate Combination, Chloramphenicol, Clavulanic Acids, Doxycycline, Drug Therapy, Combination, Female, Humans, Long-Term Care, Male, Melioidosis, Middle Aged, Patient Compliance, Prospective Studies, Recurrence, Treatment Outcome, Trimethoprim, Sulfamethoxazole Drug Combination