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Outcomes of Patients with Melioidosis Treated with Cotrimoxazole Alone for Eradication Therapy

Sarunyou ChusriDivision of Infectious Diseases, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand

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Thanaporn HortiwakulDivision of Infectious Diseases, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand

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Boonsri CharoenmakDivision of Infectious Diseases, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand

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Khachornsakdi SilpapojakulDivision of Infectious Diseases, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand

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We retrospectively reviewed a 10-year experience of administration of cotrimoxazole alone in 31 patients compared with 109 patients who received conventional eradication therapy (cotrimoxazole plus doxycycline). The baseline characteristics, the clinical manifestations, the initial intravenous antibiotic treatments, and the mean duration of eradication therapy between the two groups were similar. The culture-confirmed recurrences among the patients who received cotrimoxazole alone and those who received the conventional regimen were not significantly different (1/31 [3.2%] versus 5/109 [4.5% odds ratio = 0.69 [95% confidence interval [CI] = 0.08–6.17]). Gastrointestinal side effects were more common among the conventional regimen group (28/109 [25.7%] versus 2/31 [6.5%], P = 0.02) and the proportion of patients who could complete at least 20 weeks of therapy without having switched to the other regimen was significantly lower (91/109 [83.5%] versus 31/31 [100.0%] P = 0.01). Cotrimoxazole alone is as effective as and better tolerated than cotrimoxazole plus doxycycline for the eradication treatment of melioidosis.

Author Notes

* Address correspondence to Sarunyou Chusri, Songklanagarind Hospital, Hatyai, Songkhla, Songkhla 90110. E-mail: sarunyouchusri@hotmail.com

Authors' addresses: Sarunyou Chusri, Songklanagarind Hospital, Hatyai, Songkhla, Songkhla, E-mail: sarunyouchusri@hotmail.com. Thanaporn Hortiwakul, Boonsri Charoenmak, and Khachornsakdi Silpapojakul, Prince of Songkla University, Internal Medicine, Hatyai, Songkhla, Thailand, E-mails: hratee@medicine.psu.ac.th, cbunsri@medicine.psu.ac.th, and skhachor@medicine.psu.ac.th.

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