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Outcomes of patients with melioidosis treated with meropenem

Allen C Cheng1, Dale A Fisher, Nicholas M Anstey

  • 1Menzies School of Health Research, Charles Darwin University, Casuarina NT 0811, Northern Territory, Darwin, Australia.

Antimicrobial Agents and Chemotherapy
|April 24, 2004
PubMed

Insights

Meropenem offers a viable treatment alternative for severe melioidosis, an infection caused by Burkholderia pseudomallei. This antibiotic demonstrated comparable outcomes to ceftazidime in patients with severe melioidosis.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Melioidosis is a serious infection caused by Burkholderia pseudomallei.
  • It is endemic in Southeast Asia and Northern Australia.
  • Ceftazidime and imipenem are standard treatments.

Purpose of the Study:

  • To evaluate meropenem as a treatment for severe melioidosis.
  • To compare outcomes of meropenem with ceftazidime in a real-world setting.

Main Methods:

  • Retrospective review of 63 patients treated with meropenem for severe melioidosis over 6 years.
  • Comparison with 153 patients treated with ceftazidime.
  • Analysis of mortality and adverse events.

Main Results:

  • Meropenem treatment for severe melioidosis resulted in 19% mortality.
  • Outcomes were similar to ceftazidime, even with a bias towards sicker patients receiving meropenem.
  • One case of possible drug fever was noted with meropenem.

Conclusions:

  • Meropenem is a safe and effective alternative to ceftazidime and imipenem for treating melioidosis.
  • Intravenous meropenem (1 g every 8 h for >=14 days) is recommended.
  • Meropenem may improve outcomes in severe sepsis associated with melioidosis.

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