JAC Advance Access published online on November 28, 2002
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg011
© 2002 by The British Society for Antimicrobial Chemotherapy
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Original Paper
1 Department of Microbiology
and Immunology, James Cook University
* Corresponding author. E-mail: RobertNorton{at}health.qld.gov.au.
Received 26 February 2002
; revised 28 June 2002
; accepted 12 September 2002
Melioidosis is caused by the Gram-negative bacillus Burkholderia pseudomallei. Most clinical reports
of disease are from south-east Asia and northern Australia. The
organism is intrinsically resistant to most commonly available antibiotics.
Standard therapy includes ceftazidime either alone or in combination
with co-trimoxazole. The clinical advantage in adding co-trimoxazole has
never been determined; nor has the activity of newer, fourth-generation
cephalosporins, such as cefepime, been studied in the treatment
of this condition. BALB/c mice have been shown to represent an animal
model of melioidosis. This animal model was used in this study to compare
the efficacy of ceftazidime and cefepime alone or with co-trimoxazole,
in the therapy of melioidosis. Antibiotic levels in the mice were
determined by HPLC, and dosing was modified to keep plasma antibiotic
levels at or above the MIC for the organism-antibiotic
combination for a significant part of a 12 h period. Bacterial load,
as determined by splenic counts, showed that ceftazidime in combination
with co-trimoxazole was the most effective therapeutic option. The animal
model described in this study can be used as a preliminary evaluation
of therapeutic options for melioidosis.
A comparison of antibiotic regimens in the treatment
of acute melioidosis in a mouse model
2 Department of Microbiology
and Immunology, James Cook University
3 Department of Chemistry,
James Cook University
4 Department of Clinical Microbiology,
QHPS, Townsville Hospital, Townsville, Queensland 4814, Australia
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