title: Outcomes of patients with melioidosis treated with meropenem.
abstract: Melioidosis, an infection due to Burkholderia pseudomallei, is endemic in southeast Asia and northern Australia. We reviewed our experience with meropenem in the treatment of severe melioidosis in 63 patients over a 6-year period. Outcomes were similar to those of ceftazidime-treated patients (n = 153) despite a deliberate selection bias to more-unwell patients receiving meropenem. The mortality among meropenem-treated patients was 19%. One patient had a possible drug fever associated with the use of meropenem. We conclude that meropenem (1 g or 25 mg/kg every 8 h intravenously for >/=14 days) is an alternative to ceftazidime and imipenem in the treatment of melioidosis. The use of meropenem may be associated with improved outcomes in patients with severe sepsis associated with melioidosis.
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Casuarina NT 0811, Northern Territory, Darwin, Australia.
authors.forename: Allen C
authors.initials: AC
authors.lastname: Cheng
authors.forename: Dale A
authors.initials: DA
authors.lastname: Fisher
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Anstey
authors.forename: Dianne P
authors.initials: DP
authors.lastname: Stephens
authors.forename: Susan P
authors.initials: SP
authors.lastname: Jacups
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Currie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002442:Ceftazidime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008554:Melioidosis / Q000188:drug therapy* / Q000401:mortality; D000077731:Meropenem; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000150:complications; D013845:Thienamycins / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D002511:Cephalosporins; D013845:Thienamycins; D002442:Ceftazidime; D000077731:Meropenem