Box 2.

Antibiotics in melioidosis⁷

Doses may require adjustment in renal failure.

Intensive phase

One intravenous antibiotic for 2–4 weeks (longer if necessary), from: Ceftazidime 2 g (70 kg body weight) IV 8-hourly OR Meropenem 1 g (2 g for central nervous system infection) IV 8-hourly OR Imipenem 1 g IV 8-hourly

For deep-seated infection (eg central nervous system, prostate, bone, joints), cotrimoxazole 320:1600 mg orally 12-hourly combined with folic acid 5 mg orally daily may be added.

Adjunct therapy (for consideration): G-CSF 263 µg subcutaneously daily for 3 days

Eradication phase

Two oral antibiotics for 12–20 weeks (longer if necessary), from: Cotrimoxazole 320:1600 mg orally 12-hourly combined with folic acid 5 mg orally daily Doxycycline 100 mg orally 12-hourly Coamoxiclav 500:125 mg orally 8-hourly