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Title: Comparison of imipenem and ceftazidime as therapy for severe melioidosis
Authors: Andrew J.H. Simpson
Yupin Suputtamongkol
Michael D. Smith
Brian J. Angus
Adul Rajanuwong
Vanaporn Wuthiekanun
Paul A. Howe
Amanda L. Walsh
Wipada Chaowagul
Nicholas J. White
Mahidol University
Sappasitthiprasong Hospital
Centre for Tropical Medicine
John Radcliffe Hospital
Musgrove Park Hospital
Malaria Proj./Wellcome Trust Res. L.
Keywords: Medicine
Issue Date: 1-Jan-1999
Citation: Clinical Infectious Diseases. Vol.29, No.2 (1999), 381-387
Abstract: An open, prospective, randomized, comparative treatment trial was conducted to compare the therapeutic efficacy of high-dose intravenous imipenem and ceftazidime for acute severe melioidosis. Adult Thai patients with suspected acute, severe melioidosis were randomized to receive either imipenem, at a dosage of 50 mg/(kg · d), or ceftazidime, at a dosage of 120 mg/(kg · d), for a minimum of 10 days. The main outcome measures were death or treatment failure. Of the 296 patients enrolled, 214 had culture-confirmed melioidosis, and 132 (61.7%) of them had positive blood cultures. Mortality among patients with melioidosis was 36,9% overall. There were no differences in survival overall (P = .96) or after 48 hours (P = .3). Treatment failure after 48 hours was more common among patients treated with ceftazidime (P = .011). Both treatments were well tolerated. Imipenem is a safe and effective treatment for acute severe melioidosis and may be considered an alternative to ceftazidime.
ISSN: 10584838
Appears in Collections:Scopus 1991-2000

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