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Volume 14, Number 7—July 2008

Online Report

Peer Reviewed Report Available Online Only

Management of Accidental Laboratory Exposure to Burkholderia pseudomallei and B. mallei

Sharon J. Peacock*Comments to Author , Herbert P. Schweizer†, David A.B. Dance‡, Theresa L. Smith§, Jay E. Gee§, Vanaporn Wuthiekanun*, David DeShazer¶, Ivo Steinmetz#, Patrick Tan, and Bart J. Currie††
Author affiliations: *Mahidol University, Bangkok, Thailand; †Colorado State University, Fort Collins, Colorado, USA; ‡Health Protection Agency (South West), Plymouth, UK; §Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ¶US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA; #Universität Greifswald, Greifswald, Germany; **Genome Institute of Singapore, Singapore; ††Menzies School of Health Research and Royal Darwin Hospital, Darwin, Northern Territory, Australia;

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Table 2

Recommended Burkholderia pseudomallei postexposure antimicrobial drug prophylaxis

Antimicrobial drug Dosage Frequency
Trimethoprim-sulfamethoxazole (TMP-SMX) 2 × 160–800 mg (960 mg) tablets if >60 kg, 3 × 80–400 (480 mg) tablets if 40 kg-60 kg, and 1 × 160–800 mg (960 mg) or 2 × 80–400 (480 mg) tablets if adult <40 kg plus
folate 5 mg/d Every 12 h
Doxycycline 2.5 mg/kg/dose up to 100 mg orally Every 12 h
Amoxicillin–clavulanic acid 20/5 mg/kg/dose. Equates to 3 × 500/125 tabs if >60 kg, and 2 × 500/125 tabs if <60kg Every 8 h

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