Relapse in melioidosis: incidence and risk factors.
From 1986 to 1991, 602 patients with melioidosis were seen in Sappasitprasong Hospital, Ubon Ratchatani, Thailand. The in-hospital mortality was 42%. Of 118 adult patients followed long-term, 27 (23%) had culture-proven relapses of melioidosis (3 relapsed twice), a relapse rate of 15% (95% confidenc...
| Main Authors: | , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
1993
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| _version_ | 1826263363159588864 |
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| author | Chaowagul, W Suputtamongkol, Y Dance, D Rajchanuvong, A Pattara-arechachai, J White, N |
| author_facet | Chaowagul, W Suputtamongkol, Y Dance, D Rajchanuvong, A Pattara-arechachai, J White, N |
| author_sort | Chaowagul, W |
| collection | OXFORD |
| description | From 1986 to 1991, 602 patients with melioidosis were seen in Sappasitprasong Hospital, Ubon Ratchatani, Thailand. The in-hospital mortality was 42%. Of 118 adult patients followed long-term, 27 (23%) had culture-proven relapses of melioidosis (3 relapsed twice), a relapse rate of 15% (95% confidence interval [CI], 11-22) per year. The median time from discharge to relapse was 21 weeks (range, 1-290). In 44% of patients, relapses included septicemia, and 27% died. Patients with severe disease (multiple foci of infection or septicemia) relapsed 4.7 times (95% CI, 1.6-14.1) more frequently than patients with localized melioidosis. Underlying disease was not a risk factor, but initial parenteral treatment with ceftazidime reduced the risk of relapse 2-fold (95% CI, 1.1-3.4). Relapses were 3.3 (95% CI, 1.4-9.0) times more frequent following short-course (< or = 8 weeks) oral coamoxiclav than after the oral combination regimen of chloramphenicol, doxycycline, and cotrimoxazole. Longer oral treatment with either reduced relapse 1.6-fold (95% CI, 1.2-1.9). The optimum choice and duration of antibiotic treatment to prevent relapse in melioidosis remain to be determined. |
| first_indexed | 2024-03-06T19:50:35Z |
| format | Journal article |
| id | oxford-uuid:23d692fe-d768-4f9a-a2a5-ca854141220f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:50:35Z |
| publishDate | 1993 |
| record_format | dspace |
| spelling | oxford-uuid:23d692fe-d768-4f9a-a2a5-ca854141220f2022-03-26T11:46:28ZRelapse in melioidosis: incidence and risk factors.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:23d692fe-d768-4f9a-a2a5-ca854141220fEnglishSymplectic Elements at Oxford1993Chaowagul, WSuputtamongkol, YDance, DRajchanuvong, APattara-arechachai, JWhite, NFrom 1986 to 1991, 602 patients with melioidosis were seen in Sappasitprasong Hospital, Ubon Ratchatani, Thailand. The in-hospital mortality was 42%. Of 118 adult patients followed long-term, 27 (23%) had culture-proven relapses of melioidosis (3 relapsed twice), a relapse rate of 15% (95% confidence interval [CI], 11-22) per year. The median time from discharge to relapse was 21 weeks (range, 1-290). In 44% of patients, relapses included septicemia, and 27% died. Patients with severe disease (multiple foci of infection or septicemia) relapsed 4.7 times (95% CI, 1.6-14.1) more frequently than patients with localized melioidosis. Underlying disease was not a risk factor, but initial parenteral treatment with ceftazidime reduced the risk of relapse 2-fold (95% CI, 1.1-3.4). Relapses were 3.3 (95% CI, 1.4-9.0) times more frequent following short-course (< or = 8 weeks) oral coamoxiclav than after the oral combination regimen of chloramphenicol, doxycycline, and cotrimoxazole. Longer oral treatment with either reduced relapse 1.6-fold (95% CI, 1.2-1.9). The optimum choice and duration of antibiotic treatment to prevent relapse in melioidosis remain to be determined. |
| spellingShingle | Chaowagul, W Suputtamongkol, Y Dance, D Rajchanuvong, A Pattara-arechachai, J White, N Relapse in melioidosis: incidence and risk factors. |
| title | Relapse in melioidosis: incidence and risk factors. |
| title_full | Relapse in melioidosis: incidence and risk factors. |
| title_fullStr | Relapse in melioidosis: incidence and risk factors. |
| title_full_unstemmed | Relapse in melioidosis: incidence and risk factors. |
| title_short | Relapse in melioidosis: incidence and risk factors. |
| title_sort | relapse in melioidosis incidence and risk factors |
| work_keys_str_mv | AT chaowagulw relapseinmelioidosisincidenceandriskfactors AT suputtamongkoly relapseinmelioidosisincidenceandriskfactors AT danced relapseinmelioidosisincidenceandriskfactors AT rajchanuvonga relapseinmelioidosisincidenceandriskfactors AT pattaraarechachaij relapseinmelioidosisincidenceandriskfactors AT whiten relapseinmelioidosisincidenceandriskfactors |