Page 183 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

Melioidosis
Intensive/Induction Therapy Ceftazidime 100-200mg/kg/24h IV Meropenem 25mg/kg/24h IV q8h Duration:
in divided doses (usual dose: 1gm q8h; if CNS 2 - 3 weeks
(usual dose : 2gm q6h) infection 2gm q8h) 4 - 8 weeks if severe/ deep focal
infection
OR
PLUS/MINUS Imipenem/cilastatin 50-60mg/kg/24h Consider to add on Trimethoprim/
Trimethoprim(TMP)/ IV q6h (usual dose: 1gm q8h) sulfamethoxazole in neurologic,
sulfamethoxazole prostatic, bone, joint and deep
(80/400mg) TMP 10mg/kg/24h seated infection
IV/PO in divided doses PLUS/MINUS
Trimethoprim(TMP)/ To consider IV G-CSF for severe
sulfamethoxazole cases within 72 hours of admission
(80/400mg) TMP 10mg/kg/24h IV/PO
in divided doses Look for source of infection

Amoxicillin/clavulanate has higher
rate of relapse

Eradication/Maintenance Therapy Trimethoprim/ sulfamethoxazole Amoxicillin/clavulanate 1250mg Duration: minimum 3 months
(80/400mg) (2 tabs of 625mg) PO q8h In patients with neurological,
< 40 kg : 2 tabs q12h; osteomyelitis or non-resolving
40-60kg: 3 tabs q12h; abscess up to 6 months treatment is
>60kg. : 4 tabs q12h recommended

HPP AMG Tropical Infections 86