Ceftazidime vs. amoxicillin/clavulanate in the treatment of severe melioidosis.
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 cultur...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Sprog: | English |
| Udgivet: |
1994
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| _version_ | 1826264016430825472 |
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| author | Suputtamongkol, Y Rajchanuwong, A Chaowagul, W Dance, D Smith, MD Wuthiekanun, V Walsh, A Pukrittayakamee, S White, N |
| author_facet | Suputtamongkol, Y Rajchanuwong, A Chaowagul, W Dance, D Smith, MD Wuthiekanun, V Walsh, A Pukrittayakamee, S White, N |
| author_sort | Suputtamongkol, Y |
| collection | OXFORD |
| description | 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 > or = 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 responses 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. |
| first_indexed | 2024-03-06T20:01:04Z |
| format | Journal article |
| id | oxford-uuid:274e3877-e3a1-4d29-90ff-9612ed4ab50b |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T20:01:04Z |
| publishDate | 1994 |
| record_format | dspace |
| spelling | oxford-uuid:274e3877-e3a1-4d29-90ff-9612ed4ab50b2022-03-26T12:06:15ZCeftazidime vs. amoxicillin/clavulanate in the treatment of severe melioidosis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:274e3877-e3a1-4d29-90ff-9612ed4ab50bEnglishSymplectic Elements at Oxford1994Suputtamongkol, YRajchanuwong, AChaowagul, WDance, DSmith, MDWuthiekanun, VWalsh, APukrittayakamee, SWhite, NAn 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 > or = 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 responses 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. |
| spellingShingle | Suputtamongkol, Y Rajchanuwong, A Chaowagul, W Dance, D Smith, MD Wuthiekanun, V Walsh, A Pukrittayakamee, S White, N Ceftazidime vs. amoxicillin/clavulanate in the treatment of severe melioidosis. |
| title | Ceftazidime vs. amoxicillin/clavulanate in the treatment of severe melioidosis. |
| title_full | Ceftazidime vs. amoxicillin/clavulanate in the treatment of severe melioidosis. |
| title_fullStr | Ceftazidime vs. amoxicillin/clavulanate in the treatment of severe melioidosis. |
| title_full_unstemmed | Ceftazidime vs. amoxicillin/clavulanate in the treatment of severe melioidosis. |
| title_short | Ceftazidime vs. amoxicillin/clavulanate in the treatment of severe melioidosis. |
| title_sort | ceftazidime vs amoxicillin clavulanate in the treatment of severe melioidosis |
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