Volume 18, Number 12—December 2012
Workshop on Treatment of and Postexposure Prophylaxis for Burkholderia pseudomallei and B. mallei Infection, 2010
|Drug||Patient characteristics||Recommended dosage/frequency|
|Trimethoprim/sulfamethoxazole†||Adult, >60 kg||160 mg/800 mg tablets: 2 tablets every 12 h|
|Adult, 40–60 kg||80 mg/400 mg tablets: 3 tablets every 12 h|
|Adult, <40 kg||160 mg/800 mg tablets: 1 tablet every 12 h OR|
|80 mg/400 mg tablets: 2 tablets every 12 h|
||8 mg/40 mg/kg; maximum dose 320 mg/1,600 mg every 12 h
|Amoxicillin/clavulanic acid (co-amoxiclav)||Adult, >60 kg||500 mg/125 mg tablets: 3 tablets every 8 h‡|
|Adult, <60 kg||500 mg/125 mg tablets: 2 tablets every 8 h‡|
|Child||20 mg/5 mg/kg every 8 h; maximum dose 1,000 mg/250 mg every 8 h|
*Recommended duration of therapy is a minimum of 12 weeks.
†If the organism is susceptible and the patient does not have a documented allergy to it, oral trimethoprim/sulfamethoxazole is the agent of first choice. If the organism is resistant to trimethoprim/sulfamethoxazole or the patient is intolerant, the second-line choice is co-amoxiclav. Co-amoxiclav is available in different ratios and formulations, depending on the source country. Co-amoxiclav at a ratio of 4:1 is preferred to ensure there is sufficient clavulanate (47). Preparations of co-amoxiclav are available in the United States, with ratios of amoxicillin to clavulanic acid ranging from 2:1 to 16:1, as follows: 22:1 (Augmentin 250 mg), 4:1 (Augmentin 125 mg and 250 mg suspension, Augmentin 125 mg and 250 mg chewable tablet, Augmentin 500 mg.), 7:1 (Augmentin 200 mg and 400 mg suspension, Augmentin 400 mg chewable tablet, Augmentin 875 mg oral tablet), 14:1 (Augmentin ES-600, Amoclan 600 mg suspension) and 16:1 (Augmentin XR).
‡Weight-based dosage based on 20 mg/5 mg/kg/dose.