Serum bactericidal and inhibitory titres in the management of melioidosis.

A J Simpson, D A Dance, V Wuthiekanun, N J White

Journal: The Journal of antimicrobial chemotherapy 2000;45(1):123-7

PMID: 10629024

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Abstract

A retrospective evaluation of the relationship between serum bactericidal and inhibitory titres and treatment outcome in 195 adult Thai patients with severe melioidosis was conducted. Drug regimens included ceftazidime (52% of patients), co-amoxiclav (24%), imipenem (11%) or the conventional four-drug combination (11%). Pre- and 1 h post-dose serum samples were collected after 48-72 h of therapy, and serum inhibitory and bactericidal titrations determined. Median post-dose titres were: bactericidal 1:8 (range 0-1:128) and inhibitory 1:16 (range 0-1:128). Overall mortality was 26% and outcome was not influenced by either inhibitory or bactericidal titres. Pre-dose titres correlated with renal function; renal function was the most important predictor of mortality. Determination of serum inhibitory or bactericidal titres is unhelpful in the management of severe melioidosis.

Address: Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok 10400, Thailand. [email protected]

DOI: 10.1093/jac/45.1.123

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MeSH Terms: Adolescent, Adult, Amoxicillin-Potassium Clavulanate Combination, Anti-Bacterial Agents, Burkholderia pseudomallei, Ceftazidime, Drug Therapy, Combination, Humans, Imipenem, Kidney Function Tests, Length of Stay, Melioidosis, Middle Aged, Randomized Controlled Trials as Topic, Retrospective Studies, Serum Bactericidal Test, Treatment Outcome