Abstract
Objectives: The purpose of this study was to quantify the adverse effects from oral eradication therapy for melioidosis, which is usually with high dose trimethoprim-sulfamethoxazole for 3-6 months.
Methods: This
retrospective cohort study reviewed side effects from oral eradication therapy
in patients presenting with first episode culture-confirmed melioidosis in the
tropical north of Australia’s Northern Territory between 1st October 2012 and
1st January 2017.
Results: 234 patients presented for the first time with
culture-confirmed melioidosis. Of these, 16 (6.8%) died during the intensive
phase treatment and 6 (2.6%) did not have complete treatment at Royal Darwin
Hospital. Of the remaining 212 patients, 203 (95.8%) were initially prescribed
trimethoprim-sulfamethoxazole as oral eradication therapy, 6 (2.8%) were
prescribed doxycycline and 3 (1.4%) had no eradication therapy. Of the 203
prescribed trimethoprim-sulfamethoxazole, 61 (30.0%) experienced adverse
effects, which necessitated a cessation, a change in antibiotic or reduction in
dose.
Conclusions: In patients treated for melioidosis in northern Australia
there are high rates of adverse effects from oral
trimethoprim-sulfamethoxazole, frequently necessitating a change in therapy or
a reduction in dose. Given the side effects and low rates of oral therapy
completion in our region we emphasise the importance of the prior often
prolonged intensive phase intravenous therapy and using weight based trimethoprim-sulfamethoxazole
dosing for eradication therapy.
Original language | English |
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Pages (from-to) | 111-114 |
Number of pages | 4 |
Journal | International Journal of Infectious Diseases |
Volume | 80 |
DOIs | |
Publication status | Published - Mar 2019 |