Rebecca LipsitzSusan GargesRosemarie AurigemmaPrasith BaccamDavid D. BlaneyAllen C. ChengBart J. CurrieDavid DanceJay E. GeeJoseph LarsenDirek LimmathurotsakulMeredith G. MorrowRobert NortonElizabeth O'MaraSharon J. PeacockNicki PesikL. Paige RogersHerbert P. SchweizerIvo SteinmetzGladys TanPatrick TanW. Joost WiersingaVanaporn WuthiekanunTheresa L. SmithUnited States Department of Health and Human ServicesNational Institutes of Health, BethesdaIEMCenters for Disease Control and PreventionRoyal Darwin HospitalMenzies School of Health ResearchMonash UniversityAlfred HospitalMahosot HospitalUniversity of OxfordMahidol UniversityTownsville HospitalUniversity of CambridgeColorado State UniversityErnst-Moritz-Arndt-Universitat GreifswaldDSO National LaboratoriesGenome Institute ofDuke-NUS Graduate Medical School SingaporeAcademic Medical Centre, University of Amsterdam2018-06-112018-06-112012-12-01Emerging Infectious Diseases. Vol.18, No.12 (2012)10806059108060402-s2.0-84869773326https://repository.li.mahidol.ac.th/handle/20.500.14594/14489The US Public Health Emergency Medical Countermeasures Enterprise convened subject matter experts at the 2010 HHS Burkholderia Workshop to develop consensus recommendations for postexposure prophylaxis against and treatment for Burkholderia pseudomallei and B. mallei infections, which cause melioidosis and glanders, respectively. Drugs recommended by consensus of the participants are ceftazidime or meropenem for initial intensive therapy, and trimethoprim/sulfamethoxazole or amoxicillin/clavulanic acid for eradication therapy. For postexposure prophylaxis, recommended drugs are trimethoprim/sulfamethoxazole or co-amoxiclav. To improve the timely diagnosis of melioidosis and glanders, further development and wide distribution of rapid diagnostic assays were also recommended. Standardized animal models and B. pseudomallei strains are needed for further development of therapeutic options. Training for laboratory technicians and physicians would facilitate better diagnosis and treatment options. As of 2010, the literature did not contain broadly developed consensus recommendations for melioidosis therapy and postexposure prophylaxis (PEP) that could inform US government preparedness activities. The Public Health Emergency Medical Countermeasures Enterprise convened the 2010 HHS Burkholderia Workshop to generate expert consensus recommendations for use during a public health emergency. This enterprise is a coordinated interagency effort that is responsible for defining and prioritizing requirements for public health emergency medical countermeasures, focusing research, development, and procurement activities on the identified requirements, and establishing deployment and use strategies for medical countermeasures in the Strategic National Stockpile. A comprehensive literature review revealed consensus recommendations for other biological threat pathogens that served as a template for recommendations made during the workshop. Use of these Burkholderia recommendations will improve US government efforts in preparing for public health emergencies as well as assist clinicians in case management of melioidosis. This workshop hosted internationally recognized leaders in the field of Burkholderia spp. research and diagnostics and eminent clinicians whose expertise in the treatment for endemic melioidosis is unparalleled. The results of the workshop were achieved through structured dialogue and question-and-answer sessions. The workshop recommendations stem largely from clinical experience with melioidosis. However, the workshop participants noted that although Burkholderia mallei is sensitive to gentamicin and macrolides (in contrast to B. pseudomallei), the recommended treatment regimens and PEP for melioidosis were considered to also be appropriate for glanders. The US government will consider these expert recommendations when developing its formal policies.Mahidol UniversityMedicineWorkshop on Treatment of and Postexposure Prophylaxis for Burkholderia pseudomallei and B. mallei Infection, 2010ArticleSCOPUS10.3201/eid1812.120638