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...

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Главные авторы: Suputtamongkol, Y, Rajchanuwong, A, Chaowagul, W, Dance, D, Smith, MD, Wuthiekanun, V, Walsh, A, Pukrittayakamee, S, White, N
Формат: Journal article
Язык:English
Опубликовано: 1994
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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.
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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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