title: Effectiveness of an antimicrobial treatment scheme in a confined glanders outbreak.
abstract: BACKGROUND
  Glanders is a contagious and fatal zoonotic disease of solipeds caused by the Gram-negative bacterium Burkholderia (B.) mallei. Although regulations call for culling of diseased animals, certain situations e.g. wild life conservation, highly valuable breeding stock, could benefit from effective treatment schemes and post-exposure prophylaxis.
  
  
  RESULTS
  Twenty three culture positive glanderous horses were successfully treated during a confined outbreak by applying a treatment protocol of 12 weeks duration based on the parenteral administration of enrofloxacin and trimethoprim plus sulfadiazine, followed by the oral administration of doxycycline. Induction of immunosupression in six randomly chosen horses after completion of treatment did not lead to recrudescence of disease.
  
  
  CONCLUSIONS
  This study demonstrates that long term treatment of glanderous horses with a combination of various antibiotics seems to eliminate the agent from the organism. However, more studies are needed to test the effectiveness of this treatment regime on B. mallei strains from different endemic regions. Due to its cost and duration, this treatment can only be an option in certain situations and should not replace the current "testing and culling" policy, in conjunction with adequate compensation to prevent spreading of disease.
authors.affiliation: Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad 38040 Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Saqib
authors.forename: Ghulam
authors.initials: G
authors.lastname: Muhammad
authors.forename: Abeera
authors.initials: A
authors.lastname: Naureen
authors.forename: Muhammad H
authors.initials: MH
authors.lastname: Hussain
authors.forename: M Nadeem
authors.initials: MN
authors.lastname: Asi
authors.forename: M Khalid
authors.initials: MK
authors.lastname: Mansoor
authors.forename: Mehdi
authors.initials: M
authors.lastname: Toufeer
authors.forename: Iahtasham
authors.initials: I
authors.lastname: Khan
authors.forename: Heinrich
authors.initials: H
authors.lastname: Neubauer
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Sprague
mesh_terms: D000305:Adrenal Cortex Hormones / Q000494:pharmacology; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000145:classification / Q000627:therapeutic use*; D042726:Burkholderia mallei / Q000187:drug effects / Q000302:isolation & purification; D004196:Disease Outbreaks / Q000662:veterinary*; D005260:Female; D005896:Glanders / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D006736:Horses; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008826:Microbial Sensitivity Tests; D010154:Pakistan / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents