Andrew J.H. SimpsonYupin SuputtamongkolMichael D. SmithBrian J. AngusAdul RajanuwongVanaporn WuthiekanunPaul A. HoweAmanda L. WalshWipada ChaowagulNicholas J. WhiteMahidol UniversitySappasitthiprasong HospitalCentre for Tropical MedicineJohn Radcliffe HospitalMusgrove Park HospitalMalaria Proj./Wellcome Trust Res. L.2018-09-072018-09-071999-01-01Clinical Infectious Diseases. Vol.29, No.2 (1999), 381-387105848382-s2.0-0032777243https://repository.li.mahidol.ac.th/handle/20.500.14594/25765An 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.Mahidol UniversityMedicineArticleSCOPUS10.1086/520219