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|Title:||Ceftazidime vs. Amoxicillin/clavulanate in the treatment of severe melioidosis|
D. A.B. Dance
M. D. Smith
A. L. Walsh
N. J. White
London School of Hygiene & Tropical Medicine
John Radcliffe Hospital
|Citation:||Clinical Infectious Diseases. Vol.19, No.5 (1994), 846-853|
|Abstract:||An open, paired, randomized, controlled trial of high-dose parenteral ceftazidime (120 mg/[kg · d) vs. amoxicillin/clavulanate (160 mg/[kg · d) for the treatment of severe melioidosis was conducted in Ubon Ratchatani in northeastern Thailand. Of 379 patients enrolled in the study, 212 (56%) had culture-proven melioidosis; 106 patients were in each treatment group. The overall mortality rate (47%) was similar for both treatment groups. However, 4 of 75 surviving patients in the ceftazidime group compared with 16 of 69 surviving patients in the amoxicillin/clavulanate group were switched to the alternate regimen because of an unsatisfactory clinical response after ≥72 hours of treatment (P =.004). The overall therapeutic failure rate (i.e., treatment failure or death due to uncontrolled melioidosis) was significantly higher for the amoxicillin/clavulanate group than for the ceftazidime group (P =.02). Clinical and bacteriologic respon ses for successfully treated patients were similar in both groups, and both treatments were well tolerated. Parenteral amoxicillin/clavulanate is a safe and effective initial treatment, but parenteral ceftazidime remains the treatment of choice for severe melioidosis. © 1994 by The University of Chicago.|
|Appears in Collections:||Scopus 1991-2000|
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