A prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis.
An open randomized comparison of the oral 'conventional' regimen (combination of chloramphenicol, cotrimoxazole and doxycycline) and co-amoxiclav for the maintenance treatment of melioidosis was conducted in Ubon Ratchatani, north-eastern Thailand, between 1989 and 1992. The total antibiot...
| Main Authors: | , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
1995
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| _version_ | 1826283000053104640 |
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| author | Rajchanuvong, A Chaowagul, W Suputtamongkol, Y Smith, MD Dance, D White, N |
| author_facet | Rajchanuvong, A Chaowagul, W Suputtamongkol, Y Smith, MD Dance, D White, N |
| author_sort | Rajchanuvong, A |
| collection | OXFORD |
| description | An open randomized comparison of the oral 'conventional' regimen (combination of chloramphenicol, cotrimoxazole and doxycycline) and co-amoxiclav for the maintenance treatment of melioidosis was conducted in Ubon Ratchatani, north-eastern Thailand, between 1989 and 1992. The total antibiotic treatment duration was 20 weeks. Of 101 patients followed, 10 (10%; 95% confidence interval [CI] 4.9-17.5%) subsequently relapsed: 2 of 52 patients (4%) in the oral 'conventional' group, and 8 of 49 patients (16%) receiving oral co-amoxiclav. This compares with a relapse rate of 23% in our previous study of 8 weeks' total therapy. Only 50% of patients complied with the 20 weeks' treatment regimen and poor compliance proved the most significant risk factor for subsequent relapse (relative risk [RR] 4.9, 95% CI 1.2-20.3). Neither the presence of known underlying disease nor choice of initial parenteral treatment was significantly associated with a higher risk of relapse. Co-amoxiclav is safer and better tolerated, but may be less effective (RR of relapse 0.4, 95% CI 0.2-1.2) than the oral 'conventional' regimen. The minimum duration of total treatment with either regimen should be 12-20 weeks, depending on clinical progress. |
| first_indexed | 2024-03-07T00:52:19Z |
| format | Journal article |
| id | oxford-uuid:86cf6183-52a2-4b3b-9e74-599dfcb67a00 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:52:19Z |
| publishDate | 1995 |
| record_format | dspace |
| spelling | oxford-uuid:86cf6183-52a2-4b3b-9e74-599dfcb67a002022-03-26T22:06:34ZA prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:86cf6183-52a2-4b3b-9e74-599dfcb67a00EnglishSymplectic Elements at Oxford1995Rajchanuvong, AChaowagul, WSuputtamongkol, YSmith, MDDance, DWhite, NAn open randomized comparison of the oral 'conventional' regimen (combination of chloramphenicol, cotrimoxazole and doxycycline) and co-amoxiclav for the maintenance treatment of melioidosis was conducted in Ubon Ratchatani, north-eastern Thailand, between 1989 and 1992. The total antibiotic treatment duration was 20 weeks. Of 101 patients followed, 10 (10%; 95% confidence interval [CI] 4.9-17.5%) subsequently relapsed: 2 of 52 patients (4%) in the oral 'conventional' group, and 8 of 49 patients (16%) receiving oral co-amoxiclav. This compares with a relapse rate of 23% in our previous study of 8 weeks' total therapy. Only 50% of patients complied with the 20 weeks' treatment regimen and poor compliance proved the most significant risk factor for subsequent relapse (relative risk [RR] 4.9, 95% CI 1.2-20.3). Neither the presence of known underlying disease nor choice of initial parenteral treatment was significantly associated with a higher risk of relapse. Co-amoxiclav is safer and better tolerated, but may be less effective (RR of relapse 0.4, 95% CI 0.2-1.2) than the oral 'conventional' regimen. The minimum duration of total treatment with either regimen should be 12-20 weeks, depending on clinical progress. |
| spellingShingle | Rajchanuvong, A Chaowagul, W Suputtamongkol, Y Smith, MD Dance, D White, N A prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis. |
| title | A prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis. |
| title_full | A prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis. |
| title_fullStr | A prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis. |
| title_full_unstemmed | A prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis. |
| title_short | A prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis. |
| title_sort | prospective comparison of co amoxiclav and the combination of chloramphenicol doxycycline and co trimoxazole for the oral maintenance treatment of melioidosis |
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