Publication: Ceftazidime vs. Amoxicillin/clavulanate in the treatment of severe melioidosis
3
Issued Date
1994-01-01
Resource Type
ISSN
15376591
10584838
10584838
Other identifier(s)
2-s2.0-0028130184
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Mahidol University
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SCOPUS
Bibliographic Citation
Clinical Infectious Diseases. Vol.19, No.5 (1994), 846-853
Suggested Citation
Y. Suputtamongkol, A. Rajchanuwong, W. Chaowagul, D. A.B. Dance, M. D. Smith, V. Wuthiekanun, A. L. Walsh, S. Pukrittayakamee, N. J. White Ceftazidime vs. Amoxicillin/clavulanate in the treatment of severe melioidosis. Clinical Infectious Diseases. Vol.19, No.5 (1994), 846-853. doi:10.1093/clinids/19.5.846 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/9841
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Title
Ceftazidime vs. Amoxicillin/clavulanate in the treatment of severe melioidosis
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.