Melioidosis

Summary of changes

Medicines

  • First line antibiotic from ceftriaxone to ceftazidime (if available)
  • Note from Prof Bart Currie: 'We give ceftriaxone one dose only until patient gets to hospital where they commence ceftazidime if it is confirmed melioidosis. We don’t ever continue ceftriaxone for confirmed melioidosis but it does have activity against the bacterium so is useful while awaiting evacuation or transfer if no ceftazidime available.'

Primary references

  1. Chaowagul W, Simpson AJ, Suputtamongkol Y and White NJ (1999) 'Empirical cephalosporin treatment of melioidosis', Clinical Infectious Diseases, 28(6):1328, doi:10.1086/517787

  2. Currie BJ (2015) 'Melioidosis: evolving concepts in epidemiology, pathogenesis, and treatment', Seminars in Respiratory and Critical Care Medicine, 36(1):111-25, doi:10.1055/s-0034-1398389

  3. Dance D (2014) 'Treatment and prophylaxis of melioidosis', International Journal of Antimicrobial Agents, 43(4):310-8, doi:10.1016/j.ijantimicag.2014.01.005

  4. Expert Groups for Antibiotic, version 16 (2019) Melioidosis, Therapeutic Guidelines, accessed 24 April 2022.

  5. McLeod C, Morris PS, Bauert PA, Kilburn CJ, Ward LM, Baird RW, and Currie BJ (2015) 'Clinical presentation and medical management of melioidosis in children: a 24-year prospective study in the Northern Territory of Australia and review of the literature', Clinical Infectious Diseases, 60(1):21-6, doi:10.1093/cid/ciu733

  6. Sullivan RP, Marshall CS, Anstey NM, Ward L and Currie BJ (2020) '2020 Review and revision of the 2015 Darwin melioidosis treatment guideline; paradigm drift not shift', PLOS Neglected Tropical Diseases, 14(9):e0008659, doi:10.1371/journal.pntd.0008659

  7. Wiersinga WJ, Virk HS, Torres AG, Currie BJ, Peacock SJ, Dance DAB and Limmathurotsakul D (2018) 'Melioidosis', Nature Reviews Disease Primers, 4:17107, doi:10.1038/nrdp.2017.107