{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:50:52Z","timestamp":1791910252611,"version":"4.3.4"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Contemporary Australian guidelines for the management of melioidosis recommend a longer duration of intravenous antibiotics during the intensive phase of treatment; recurrent disease is now far less common. A high rate of adverse drug reactions (ADRs) to the currently recommended minimum of 3 months of oral trimethoprim\/sulfamethoxazole (TMP\/SMX) eradication therapy questions the incremental value of this phase of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this pilot, single-center, open-label randomized controlled trial, adults with culture-confirmed melioidosis received either prolonged intravenous intensive-phase therapy followed by oral eradication-phase therapy with TMP\/SMX (standard therapy) or prolonged intravenous intensive-phase therapy alone (short-course therapy). The primary outcome was culture-confirmed recurrence at 2 years. Secondary outcomes included clinical (culture-unconfirmed) recurrence and ADRs to TMP\/SMX.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 33 participants, 5 had culture-confirmed recurrence: 0\/16 in the standard therapy group and 5\/17 (29%) in the short-course therapy group. One participant (6%) in the standard therapy group had clinical recurrence. An ADR to TMP\/SMX occurred in 13\/16 (81%) in the standard therapy group, necessitating TMP\/SMX cessation in 7\/13 (44%), hospitalization in 5\/13 (38%), and intensive care unit admission in 1\/13 (8%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prolonged intravenous antibiotics alone will cure many patients with melioidosis; however, some still require oral eradication therapy. The potential for recurrence of life-threatening melioidosis must be balanced against the high rate of significant ADRs to high-dose TMP\/SMX. This necessitates a greater understanding of the individuals at highest risk of recurrence and determination of the optimal dosing and duration of eradication therapy in those who need it.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag591","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:34:59Z","timestamp":1789673699000},"source":"Crossref","is-referenced-by-count":0,"title":["Omitting the Eradication Phase of Treatment of Adults with Melioidosis: A Pilot, Single-Center Randomized Controlled Trial"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7770-3738","authenticated-orcid":false,"given":"Simon","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Medicine, Cairns Hospital , Cairns, Queensland 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