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Title: Relapse in Melioidosis: Incidence and Risk Factors
Authors: Y. Suputtamongkol
W. Chaowagul
D. A.B. Dance
A. Rajchanuvong
J. Pattara
N. J. White
Mahidol University
London School of Hygiene & Tropical Medicine
John Radcliffe Hospital
Keywords: Medicine
Issue Date: 1-Jan-1993
Citation: Journal of Infectious Diseases. Vol.168, No.5 (1993), 1181-1185
Abstract: From 1986 to 1991, 602 patients with melioidosis were seen in Sappasitprasong Hospital, Ubon Ratchatani, Thailand. The in-hospital mortality was 42%. Of 118 adult patients followed long-term, 27 (23%) had culture-proven relapses of melioidosis (3 relapsed twice), a relapse rate of 15% (95% confidence interval [CI], 11–22) per year. The median time from discharge to relapse was 21 weeks (range, 1–290). In 44% of patients, relapses included septicemia, and 27% died. Patients with severe disease (multiple foci of infection or septicemia) relapsed 4.7 times (95% Cl, 1.6–14.1) more frequently than patients with localized melioidosis. Underlying disease was not a risk factor, but initial parenteral treatment with ceftazidime reduced the risk of relapse 2-fold (95% CI, 1.1–3.4). Relapses were 3.3 (95% CI, 1.4–9.0) times more frequent following short-course (⩾8 weeks) oral coamoxiclav than after the oral combination regimen of chloramphenicol, doxycycline, and cotrimoxazole. Longer oral treatment with either reduced relapse 1.6-fold (95% CI, 1.2–1.9). The optimum choice and duration of antibiotic treatment to prevent relapse in melioidosis remain to be determined. © 1993 by The University of Chicago.
ISSN: 15376613
Appears in Collections:Scopus 1991-2000

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