Table 5. 2020 Revised Darwin melioidosis guideline.

Antibiotic Duration Determining Focus	Minimum intensive phase duration (weeks)a	Eradication phase duration (months) f
Skin abscess	2	3
Bacteraemia with no focus	2	3
Unilateral unilobar pneumonia without lymphadenopathyb, ICU admission, and with negative blood cultures	2	3
Multilobar unilateral or bilateral pneumonia without lymphadenopathyb, ICU admission and with negative blood cultures OR Unilateral unilobar pneumonia without lymphadenopathyb, ICU admission, but with positive blood cultures	3	3
Pneumonia with either lymphadenopathyb or ICU admission OR Multilobar unilateral or bilateral pneumonia with positive blood cultures	4	3
Deep-seated collectionc	4d	3
Osteomyelitis	6	6
Central nervous system infection	8	6
Arterial infectione	8d	6 g

^a Clinical judgement to guide prolongation of intensive phase if improvement is slow or if blood cultures remain positive at 7 days

^b Defined as enlargement of any hilar or mediastinal lymph node to greater than 10 mm diameter

^c Defined as abscess anywhere other than skin, lungs, bone, CNS or vasculature. Septic arthritis is considered a deep-seated collection

^d Intensive phase duration is timed from the date of the most recent drainage or resection where culture of the drainage specimen or resected material grew B. pseudomallei or where no specimen was sent for culture; clock is not reset if specimen is culture-negative

^e Most commonly presenting as mycotic aneurysm

^f If concurrent oral therapy is not indicated in the intensive phase, oral eradication therapy to commence at the start of the final week of planned intensive intravenous therapy, with the timing of eradication duration commencing from the day after last intravenous therapy.

^g Life-long suppressive antibiotic therapy may be required following vascular prosthetic surgery.