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Original ArticleOpen Access
Cefoperazone/Sulbactam + Co-trimoxazole vs Ceftazidime + Co-trimoxazole in the Treatment of Severe Melioidosis : A Randomized, Double-Blind, Controlled Study
Thamprajamchit S 
,
Chetchotisakd P ,
Thinkhamrop B
,
Chetchotisakd P ,
Thinkhamrop B A prospective randomized, double-blind, controlled study of cefoperazone/sulbactam
(cefoperazone 25 mg/kg/day) + co-trimoxazole (trimethoprim 8 mg/kg/day) vs ceftazidime (100
mg/kg/day) + co-trimoxazole (trimethoprim 8 mg/kg/day) in the treatment of severe melioidosis
was conducted at Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand, from July
1995 to September 1996. A total of 84 patients were enrolled in the study. Forty of them (48%)
had culture-proven melioidosis and were randomly assigned to one of the two treatment groups,
each group with 20 patients. Two cases (one in each treatment group) were excluded from the
final analysis due to incomplete data. There was no significant difference in the mortality rate
between the two groups - 16 per cent (3/19) in the cefoperazone/sulbactam group vs 21 per cent
( 4/19) in the ceftazidime group (p>0.05). Bacteriological responses of successfully treated
patients were similar in both groups, and both treatment regimens were well tolerated.
Cefoperazone/sulbactam + co-trimoxazole can therefore be used as an alternative treatment
for severe melioidosis. However, to further support this conclusion, a study with a larger
patient population is needed.
(cefoperazone 25 mg/kg/day) + co-trimoxazole (trimethoprim 8 mg/kg/day) vs ceftazidime (100
mg/kg/day) + co-trimoxazole (trimethoprim 8 mg/kg/day) in the treatment of severe melioidosis
was conducted at Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand, from July
1995 to September 1996. A total of 84 patients were enrolled in the study. Forty of them (48%)
had culture-proven melioidosis and were randomly assigned to one of the two treatment groups,
each group with 20 patients. Two cases (one in each treatment group) were excluded from the
final analysis due to incomplete data. There was no significant difference in the mortality rate
between the two groups - 16 per cent (3/19) in the cefoperazone/sulbactam group vs 21 per cent
( 4/19) in the ceftazidime group (p>0.05). Bacteriological responses of successfully treated
patients were similar in both groups, and both treatment regimens were well tolerated.
Cefoperazone/sulbactam + co-trimoxazole can therefore be used as an alternative treatment
for severe melioidosis. However, to further support this conclusion, a study with a larger
patient population is needed.
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