Journal Article

Randomized, Double-Blind, Controlled Study of Cefoperazone-Sulbactam Plus Cotrimoxazole versus Ceftazidime Plus Cotrimoxazole for the Treatment of Severe Melioidosis

Ploenchan Chetchotisakd, Sriurai Porramatikul, Piroon Mootsikapun, Siriluck Anunnatsiri and Bandit Thinkhamrop

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 1, pages 29-34
Published in print July 2001 | ISSN: 1058-4838
Published online July 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/320878
Randomized, Double-Blind, Controlled Study of Cefoperazone-Sulbactam Plus Cotrimoxazole versus Ceftazidime Plus Cotrimoxazole for the Treatment of Severe Melioidosis

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We conducted a prospective randomized, double-blind, controlled study of cefoperazone-sulbactam (ratio, 1 : 1; cefoperazone 25 mg/kg/day) plus cotrimoxazole (trimethoprim-sulfamethoxazole [TMP-SMZ] at a ratio of 80 : 400; TMP, 8 mg/kg/day) versus ceftazidime (100 mg/kg/day) plus cotrimoxazole (TMP, 8 mg/kg/day) for the treatment of severe melioidosis. Of 219 patients enrolled in the study, 102 (47%) had culture-proven melioidosis. These patients were assigned randomly to 2 treatment groups, each with 50 patients (2 patients were excluded). Mortality rates were not significantly different between the 2 groups: 18% in the cefoperazone-sulbactam group versus 14% in the ceftazidime group. The crude difference in the mortality rate was 4%, but when adjusted for type of infection the difference was 0.9% (95% confidence interval, −3.6% to 5.4%; P = .696). The duration of defervescence and the bacteriological response of successfully treated patients were similar in both groups, and both treatment regimens were well tolerated. Cefoperazone-sulbactam plus cotrimoxazole might be used as an alternative to ceftazidime plus cotrimoxazole as treatment for severe melioidosis.

Journal Article.  2950 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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