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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 3

Treatment of melioidosis

Initial parenteral therapy
Ceftazidime 50 mg/kg/dose (up to 2 g) every 6–8 h,* or meropenem 25 mg/kg/dose (up to 1 g) every 8 h*
Duration of therapy a minimum of 10–14 d, and longer (4–8 wk) for deep-seated infection
Oral eradication therapy
Trimethoprim-sulfamethoxazole orally every 12 h
 2 × 160–800 mg (960 mg) tablets if >60 kg, 3 × 80–400 (480 mg) tablets if 40–60 kg, and 1 × 160–800 mg (960 mg) or 2 × 80–400 (480 mg) tablets if adult <40 kg; ± doxycycline 2.5 mg/kg/dose up to 100 mg orally every 12 h plus folate 5 mg/d
 Duration at least 3–6 mo

*Plus trimethoprim-sulfamethoxazole 8/40 mg/kg (up to 320/1,600 mg) every 12 h for treatment of patients with neurologic, prostatic, bone, or joint melioidosis.

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