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Title: Workshop on Treatment of and Postexposure Prophylaxis for Burkholderia pseudomallei and B. mallei Infection, 2010
Authors: Rebecca Lipsitz
Susan Garges
Rosemarie Aurigemma
Prasith Baccam
David D. Blaney
Allen C. Cheng
Bart J. Currie
David Dance
Jay E. Gee
Joseph Larsen
Direk Limmathurotsakul
Meredith G. Morrow
Robert Norton
Elizabeth O'Mara
Sharon J. Peacock
Nicki Pesik
L. Paige Rogers
Herbert P. Schweizer
Ivo Steinmetz
Gladys Tan
Patrick Tan
W. Joost Wiersinga
Vanaporn Wuthiekanun
Theresa L. Smith
United States Department of Health and Human Services
National Institutes of Health, Bethesda
Centers for Disease Control and Prevention
Royal Darwin Hospital
Menzies School of Health Research
Monash University
Alfred Hospital
Mahosot Hospital
University of Oxford
Mahidol University
Townsville Hospital
University of Cambridge
Colorado State University
Ernst-Moritz-Arndt-Universitat Greifswald
DSO National Laboratories
Genome Institute of
Duke-NUS Graduate Medical School Singapore
Academic Medical Centre, University of Amsterdam
Keywords: Medicine
Issue Date: 1-Dec-2012
Citation: Emerging Infectious Diseases. Vol.18, No.12 (2012)
Abstract: The US Public Health Emergency Medical Countermeasures Enterprise convened subject matter experts at the 2010 HHS Burkholderia Workshop to develop consensus recommendations for postexposure prophylaxis against and treatment for Burkholderia pseudomallei and B. mallei infections, which cause melioidosis and glanders, respectively. Drugs recommended by consensus of the participants are ceftazidime or meropenem for initial intensive therapy, and trimethoprim/sulfamethoxazole or amoxicillin/clavulanic acid for eradication therapy. For postexposure prophylaxis, recommended drugs are trimethoprim/sulfamethoxazole or co-amoxiclav. To improve the timely diagnosis of melioidosis and glanders, further development and wide distribution of rapid diagnostic assays were also recommended. Standardized animal models and B. pseudomallei strains are needed for further development of therapeutic options. Training for laboratory technicians and physicians would facilitate better diagnosis and treatment options. As of 2010, the literature did not contain broadly developed consensus recommendations for melioidosis therapy and postexposure prophylaxis (PEP) that could inform US government preparedness activities. The Public Health Emergency Medical Countermeasures Enterprise convened the 2010 HHS Burkholderia Workshop to generate expert consensus recommendations for use during a public health emergency. This enterprise is a coordinated interagency effort that is responsible for defining and prioritizing requirements for public health emergency medical countermeasures, focusing research, development, and procurement activities on the identified requirements, and establishing deployment and use strategies for medical countermeasures in the Strategic National Stockpile. A comprehensive literature review revealed consensus recommendations for other biological threat pathogens that served as a template for recommendations made during the workshop. Use of these Burkholderia recommendations will improve US government efforts in preparing for public health emergencies as well as assist clinicians in case management of melioidosis. This workshop hosted internationally recognized leaders in the field of Burkholderia spp. research and diagnostics and eminent clinicians whose expertise in the treatment for endemic melioidosis is unparalleled. The results of the workshop were achieved through structured dialogue and question-and-answer sessions. The workshop recommendations stem largely from clinical experience with melioidosis. However, the workshop participants noted that although Burkholderia mallei is sensitive to gentamicin and macrolides (in contrast to B. pseudomallei), the recommended treatment regimens and PEP for melioidosis were considered to also be appropriate for glanders. The US government will consider these expert recommendations when developing its formal policies.
ISSN: 10806059
Appears in Collections:Scopus 2011-2015

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