Workshop on Treatment of and Postexposure Prophylaxis for Burkholderia pseudomallei and B. mallei Infection, 2010
Rebecca Lipsitz

, Susan Garges, Rosemarie Aurigemma, Prasith Baccam, David D. Blaney, Allen C. Cheng, Bart J. Currie, David Dance, Jay E. Gee, Joseph Larsen, Direk Limmathurotsakul, Meredith G. Morrow, Robert Norton, Elizabeth O’Mara, Sharon J. Peacock, Nicki Pesik, L. Paige Rogers, Herbert P. Schweizer, Ivo Steinmetz, Gladys Tan, Patrick Tan, W. Joost Wiersinga, Vanaporn Wuthiekanun, and Theresa L. Smith
Author affiliations: Author affiliations: Department of Health and Human Services, Washington, DC, USA (R. Lipsitz, J. Larsen, L.P. Rogers); National Institutes of Health, Bethesda, Maryland, USA (S. Garges, R. Aurigemma); IEM, Research Triangle Park, North Carolina, USA (P. Baccam); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (D. Blaney, J.E. Gee, M. Morrow, E. O’Mara, N. Pesik, T. Smith); Royal Darwin Hospital, Casuarina, Northern Territory, Australia (A. Cheng, B.J. Currie); Menzies School of Health Research, Casuarina, (A. Cheng, B.J. Currie); Monash University Melbourne, Victoria, Australia (A. Cheng); Alfred Hospital, Melbourne (A. Cheng); Mahosot Hospital, Vientiane, Laos (D. Dance); University of Oxford, Oxford, UK (D. Dance); Mahidol University, Bangkok, Thailand (D. Limmathurotsakul, S.J. Peacock, V. Wuthiekanun); Townsville Hospital, Townsville, Queensland, Australia (R. Norton); University of Cambridge, Cambridge, UK (S. Peacock); Colorado State University, Fort Collins, Colorado, USA (H.P. Schweizer); University of Greifswald, Greifswald, Germany (I. Steinmetz); DSO National Laboratories, Singapore (G. Tan); Genome Institute of Singapore, Singapore (P. Tan); Duke–National University of Singapore Graduate Medical School, Singapore (P. Tan); and Academic Medical Center, Amsterdam, the Netherlands (J. Wiersinga)
Main Article
Table 2
Workshop results for oral eradication-phase therapy for Burkholderia pseudomallei and Bmallei infections during a public health emergency, 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 |
|
Child
|
8 mg/40 mg/kg; maximum dose 320 mg/1,600 mg every 12 h
|
OR
|
|
|
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 |
Main Article
References
Smith MD,
Wuthiekanun V,
Walsh AL,
White NJ.
Quantitative recovery of Burkholderia pseudomallei from soil in Thailand. Trans R Soc Trop Med Hyg.
1995;
89:
488–
90 and .
DOIPubMed Millan JM,
Mayo M,
Gal D,
Janmaat A,
Currie BJ.
Clinical variation in melioidosis in pigs with clonal infection following possible environmental contamination from bore water. Vet J.
2007;
174:
200–
2 and .
DOIPubMed White NJ.
Melioidosis. Lancet.
2003;
361:
1715–
22 and .
DOIPubMed Currie BJ,
Jacups SP,
Cheng AC,
Fisher DA,
Anstey NM,
Huffam SE,
Melioidosis epidemiology and risk factors from a prospective whole-population study in northern Australia. Trop Med Int Health.
2004;
9:
1167–
74 and .
DOIPubMed Stone R.
Infectious disease. Racing to defuse a bacterial time bomb. Science.
2007;
317:
1022–
4 and .
DOIPubMed Currie BJ,
Ward L,
Cheng AC.
The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis.
2010;
4:
e900 and .
DOIPubMed Currie BJ.
Melioidosis: an important cause of pneumonia in residents of and travellers returned from endemic regions. Eur Respir J.
2003;
22:
542–
50 and .
DOIPubMed Puthucheary SD,
Parasakthi N,
Lee MK.
Septicaemic melioidosis: a review of 50 cases from Malaysia. Trans R Soc Trop Med Hyg.
1992;
86:
683–
5 and .
DOIPubMed Currie BJ,
Ward L,
Cheng AC.
The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis.
2010;
4:
e900 and .
DOIPubMed Currie BJ,
Fisher DA,
Howard DM,
Burrow JN,
Selvanayagam S,
Snelling PL,
The epidemiology of melioidosis in Australia and Papua New Guinea. Acta Trop.
2000;
74:
121–
7 and .
DOIPubMed Ngauy V,
Lemeshev Y,
Sadkowski L,
Crawford G.
Cutaneous melioidosis in a man who was taken as a prisoner of war by the Japanese during World War II. J Clin Microbiol.
2005;
43:
970–
2 and .
DOIPubMed Chierakul W,
Winothai W,
Wattanawaitunechai C,
Wuthiekanun V,
Rugtaengan T,
Rattanalertnavee J,
Melioidosis in 6 tsunami survivors in southern Thailand. Clin Infect Dis.
2005;
41:
982–
90 and .
DOIPubMed Limmathurotsakul D,
Jamsen K,
Arayawichanont A,
Simpson JA,
White LJ,
Lee SJ,
Defining the true sensitivity of culture for the diagnosis of melioidosis using Bayesian latent class models. PLoS ONE.
2010;
5:
e12485 and .
DOIPubMed Bowers JR,
Engelthaler DM,
Ginther JL,
Pearson T,
Peacock SJ,
Tuanyok A,
BurkDiff: a real-time PCR allelic discrimination assay for Burkholderia pseudomallei and B. mallei. PLoS ONE.
2010;
5:
e15413 and .
DOIPubMed Antonov VA,
Tkachenko GA,
Altukhova VV,
Savchenko SS,
Zinchenko OV,
Viktorov DV,
Molecular identification and typing of Burkholderia pseudomallei and Burkholderia mallei: when is enough enough? Trans R Soc Trop Med Hyg.
2008;
102(
Suppl 1):
S134–
9 and .
DOIPubMed Ashdown LR.
An improved screening technique for isolation of Pseudomonas pseudomallei from clinical specimens. Pathology.
1979;
11:
293–
7 and .
DOIPubMed Trunck LA,
Propst KL,
Wuthiekanun V,
Tuanyok A,
Beckstrom-Sternberg SM,
Beckstrom-Sternberg JS,
Molecular basis of rare aminoglycoside susceptibility and pathogenesis of Burkholderia pseudomallei clinical isolates from Thailand. PLoS Negl Trop Dis.
2009;
3:
e519 and .
DOIPubMed Peacock SJ,
Chieng G,
Cheng AC,
Dance DA,
Amornchai P,
Wongsuvan G,
Comparison of Ashdown's medium, Burkholderia cepacia medium, and Burkholderia pseudomallei selective agar for clinical isolation of Burkholderia pseudomallei. J Clin Microbiol.
2005;
43:
5359–
61 and .
DOIPubMed Lowe P,
Haswell H,
Lewis K.
Use of various common isolation media to evaluate the new VITEK 2 colorimetric GN card for identification of Burkholderia pseudomallei. J Clin Microbiol.
2006;
44:
854–
6 and .
DOIPubMed Amornchai P,
Chierakul W,
Wuthiekanun V,
Mahakhunkijcharoen Y,
Phetsouvanh R,
Currie BJ,
Accuracy of Burkholderia pseudomallei identification using the API 20NE system and a latex agglutination test. J Clin Microbiol.
2007;
45:
3774–
6 and .
DOIPubMed Wuthiekanun V,
Desakorn V,
Wongsuvan G,
Amornchai P,
Cheng AC,
Maharjan B,
Rapid immunofluorescence microscopy for diagnosis of melioidosis. Clin Diagn Lab Immunol.
2005;
12:
555–
6 .
PubMed Tiangpitayakorn C,
Songsivilai S,
Piyasangthong N,
Dharakul T.
Speed of detection of Burkholderia pseudomallei in blood cultures and its correlation with the clinical outcome. Am J Trop Med Hyg.
1997;
57:
96–
9 .
PubMed Wuthiekanun V,
Peacock SJ.
Management of melioidosis. Expert Rev Anti Infect Ther.
2006;
4:
445–
55 and .
DOIPubMed Chantratita N,
Rholl DA,
Sim B,
Wuthiekanun V,
Limmathurotsakul D,
Amornchai P,
Antimicrobial resistance to ceftazidime involving loss of penicillin-binding protein 3 in Burkholderia pseudomallei. Proc Natl Acad Sci U S A.
2011;
108:
17165–
70 and .
DOIPubMed Rholl DA, Papp-Wallace K, Tomaras AP, Vasil ML, Bonomo RA, Schwezer HP. Molecular investigations of PenA-mediated β-lactam resistance in Burkholderia pseudomallei. Front Microbiol. 2011;2:139.
Chierakul W,
Anunnatsiri S,
Chaowagul W,
Peacock SJ,
Chetchotisakd P,
Day NP.
Addition of trimethoprim-sulfamethoxazole to ceftazidime during parenteral treatment of melioidosis is not associated with a long-term outcome benefit. Clin Infect Dis.
2007;
45:
521–
3 and .
DOIPubMed Suputtamongkol Y,
Rajchanuwong A,
Chaowagul W,
Dance DA,
Smith MD,
Wuthiekanun VJ,
Ceftazidime vs. amoxicillin/clavulanate in the treatment of severe melioidosis. Clin Infect Dis.
1994;
19:
846–
53 and .
DOIPubMed Karunakaran R,
Puthucheary SD.
Burkholderia pseudomallei: in vitro susceptibility to some new and old antimicrobials. Scand J Infect Dis.
2007;
39:
858–
61 and .
DOIPubMed Harris P,
Engler C,
Norton R.
Comparative in vitro susceptibility of Burkholderia pseudomallei to doripenem, ertapenem, tigecycline and moxifloxacin. Int J Antimicrob Agents.
2011;
37:
547–
9 and . .
DOIPubMed Sookpranee T,
Sookpranee M,
Mellencamp MA,
Preheim LC.
Pseudomonas pseudomallei, a common pathogen in Thailand that is resistant to the bactericidal effects of many antibiotics. Antimicrob Agents Chemother.
1991;
35:
484–
9 and .
DOIPubMed Thibault FM,
Hernandez E,
Vidal DR,
Girardet M,
Cavallo JD.
Antibiotic susceptibility of 65 isolates of Burkholderia pseudomallei and Burkholderia mallei to 35 antimicrobial agents. J Antimicrob Chemother.
2004;
54:
1134–
8 and . .
DOIPubMed Jenney AW,
Lum G,
Fisher DA,
Currie BJ.
Antibiotic susceptibility of Burkholderia pseudomallei from tropical northern Australia and implications for therapy of melioidosis. Int J Antimicrob Agents.
2001;
17:
109–
13 and .
DOIPubMed Chaowagul W,
Simpson A,
Suputtamongkol Y,
White N.
Empirical cephalosporin treatment of melioidosis. Clin Infect Dis.
1999;
28:
1328–
30 and .
DOIPubMed Dellinger RP,
Levy MM,
Carlet JM,
Bion J,
Parker MM,
Jaeschke R,
Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. .
Crit Care Med.
2008;
36:
296–
327 and .
DOIPubMed Rajchanuvong A,
Chaowagul W,
Suputtamongkol Y,
Smith MD,
Dance DA,
White NJ.
A prospective comparison of co-amoxiclav and the combination of chloramphenicol, doxycycline, and co-trimoxazole for the oral maintenance treatment of melioidosis. Trans R Soc Trop Med Hyg.
1995;
89:
546–
9 and .
DOIPubMed Chaowagul W,
Simpson AJ,
Suputtamongkol Y,
Smith MD,
Angus BJ,
White NJ.
A comparison of chloramphenicol, trimethoprim-sulfamethoxazole, and doxycycline with doxycycline alone as maintenance therapy for melioidosis. Clin Infect Dis.
1999;
29:
375–
80 and .
DOIPubMed Cheng AC,
Currie BJ.
Melioidosis: epidemiology, pathophysiology, and management. 2007;20. .
Clin Microbiol Rev.
2005;
18:
383–
416 and .
DOIPubMed Currie BJ,
Fisher DA,
Howard DM,
Burrow JN,
Lo D,
Selva-Nayagam S,
Endemic melioidosis in tropical northern Australia: a 10-year prospective study and review of the literature. Clin Infect Dis.
2000;
31:
981–
6 and .
DOIPubMed Wen SW,
Zhou J,
Yang Q,
Fraser W,
Olatunbosun O,
Walker M.
Maternal exposure to folic acid antagonists and placenta-mediated adverse pregnancy outcomes. CMAJ.
2008;
179:
1263–
8 and .
DOIPubMed Limmathurotsakul D,
Chaowagul W,
Chierakul W,
Stepniewska K,
Maharjan B,
Wuthiekanun V,
Risk factors for recurrent melioidosis in northeast Thailand. Clin Infect Dis.
2006;
43:
979–
86 and .
DOIPubMed Dance DA,
Wuthiekanun V,
Chaowagul W,
White NJ.
The activity of amoxycillin/clavulanic acid against Pseudomonas pseudomallei. J Antimicrob Chemother.
1989;
24:
1012–
4 and .
DOIPubMed Peacock SJ,
Schweizer HP,
Dance DAB,
Smith TL,
Gee JE,
Wuthiekanun V,
Management of accidental laboratory exposure to Burkholderia pseudomallei and B. mallei. Emerg Infect Dis.
2008;
14:
e2 and .
DOIPubMed Sivalingam SP,
Sim SH,
Jasper LC,
Wang D,
Liu Y,
Ooi EE.
Pre- and post-exposure prophyalxis of experimental Burkholderia pseudomallei infection with doxycycline, amoxicillin/calvulanic acid and co-trimoxazole. J Antimicrob Chemother.
2008;
61:
674–
8 and .
DOIPubMed Feterl M,
Govan B,
Engler C,
Norton R,
Ketheesan N.
Activity of tigecycline in the treatment of acute Burkholderia pseudomallei infection in a murine model. Int J Antimicrob Agents.
2006;
28:
460–
4 and .
DOIPubMed Ulett GC,
Hirst R,
Bowden B,
Powell K,
Norton R.
A comparison of antibiotic regimens in the treatment of acute melioidosis in a mouse model. J Antimicrob Chemother.
2003;
51:
77–
81 and .
DOIPubMed Warawa JM. Evaluation of surrogate animal models of melioidosis. Front Microbiol. 2010;1:141. .
Cheng AC,
Chierakul W,
Chaowagul W,
Chetchotisakd P,
Limmathurotsakul D,
Dance DA,
Consensus guidelines for dosing of amoxicillin-clavulanate in melioidosis. Am J Trop Med Hyg.
2008;
78:
208–
9 .
PubMed
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