Y. SuputtamongkolA. RajchanuwongW. ChaowagulD. A.B. DanceM. D. SmithV. WuthiekanunA. L. WalshS. PukrittayakameeN. J. WhiteMahidol UniversitySappasitthiprasong HospitalLondon School of Hygiene & Tropical MedicineJohn Radcliffe Hospital2018-02-272018-02-271994-01-01Clinical Infectious Diseases. Vol.19, No.5 (1994), 846-85315376591105848382-s2.0-0028130184https://repository.li.mahidol.ac.th/handle/123456789/9841An 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.Mahidol UniversityMedicineArticleSCOPUS10.1093/clinids/19.5.846