Publication: A prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis
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Issued Date
1995-01-01
Resource Type
ISSN
18783503
00359203
00359203
Other identifier(s)
2-s2.0-0028841793
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Mahidol University
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SCOPUS
Bibliographic Citation
Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.89, No.5 (1995), 546-549
Suggested Citation
A. Rajchanuvong, W. Chaowagul, Y. Suputtamongkol, M. D. Smith, D. A.B. Dance, N. J. White A prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis. Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.89, No.5 (1995), 546-549. doi:10.1016/0035-9203(95)90104-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/17331
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Title
A prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis
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Abstract
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%) inthe 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’ totaltherapy. 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 patenteral treatment was significantly associated with a higher risk of relapse. Co-amoxiclav is saferand better tolerated, but may be less effective (RR of relapse 0.4, 95%CI 0.2—1.2) thanthe oral ‘conventional’ regimen. The minimum duration of total treatment with either regimen should be 12—20 weeks, depending on clinical progress. © 1995 Oxford University Press.