Abstract
A retrospective evaluation of the relationship between serum bactericidal and inhibitory titres and treatment outcome in 195 adult Thai patients with severe melioidosis was conducted. Drug regimens included ceftazidime (52% of patients), co-amoxiclav (24%), imipenem (11%) or the conventional four-drug combination (11%). Pre- and 1 h post-dose serum samples were collected after 48-72 h of therapy, and serum inhibitory and bactericidal titrations determined. Median post-dose titres were: bactericidal 1:8 (range 0-1:128) and inhibitory 1:16 (range 0-1:128). Overall mortality was 26% and outcome was not influenced by either inhibitory or bactericidal titres. Pre-dose titres correlated with renal function; renal function was the most important predictor of mortality. Determination of serum inhibitory or bactericidal titres is unhelpful in the management of severe melioidosis.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adolescent
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Adult
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Amoxicillin-Potassium Clavulanate Combination / blood
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Amoxicillin-Potassium Clavulanate Combination / pharmacology
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Amoxicillin-Potassium Clavulanate Combination / therapeutic use
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Anti-Bacterial Agents / blood
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Anti-Bacterial Agents / pharmacology
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Anti-Bacterial Agents / therapeutic use*
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Burkholderia pseudomallei / drug effects*
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Ceftazidime / blood
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Ceftazidime / pharmacology
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Ceftazidime / therapeutic use
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Drug Therapy, Combination / blood
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Drug Therapy, Combination / therapeutic use*
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Humans
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Imipenem / blood
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Imipenem / pharmacology
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Imipenem / therapeutic use
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Kidney Function Tests
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Length of Stay
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Melioidosis / drug therapy*
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Melioidosis / microbiology
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Middle Aged
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Randomized Controlled Trials as Topic
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Retrospective Studies
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Serum Bactericidal Test
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Treatment Outcome
Substances
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Anti-Bacterial Agents
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Imipenem
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Amoxicillin-Potassium Clavulanate Combination
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Ceftazidime