{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:12:41Z","timestamp":1791421961525,"version":"4.3.3"},"reference-count":12,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2005,10,1]],"date-time":"2005-10-01T00:00:00Z","timestamp":1128124800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2005,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Melioidosis (infection caused by\n            <jats:italic>Burkholderia pseudomallei<\/jats:italic>\n            ) requires a prolonged course of oral antibiotics following initial intravenous therapy to reduce the risk of relapse after cessation of treatment. The current recommendation is a four-drug regimen (trimethoprim [TMP], sulfamethoxazole [SMX], doxycycline, and chloramphenicol) and a total treatment time of 12 to 20 weeks. Drug side effects are common; the aim of this study was to compare the efficacy and tolerance of the four-drug regimen with a three-drug regimen (TMP-SMX and doxycycline). An open-label, randomized trial was conducted in northeast Thailand. A total of 180 adult Thai patients were enrolled, of which 91 were allocated to the four-drug regimen and 89 to the three-drug regimen. The trial was terminated early due to poor drug tolerance, particularly of the four-drug regimen. The culture-confirmed relapse rates at 1 year were 6.6% and 5.6% for the four- and three-drug regimens, respectively (\n            <jats:italic>P<\/jats:italic>\n            = 0.79). The three-drug regimen was better tolerated than the four-drug regimen; 36% of patients receiving four drugs and 19% of patients receiving three drugs required a switch in therapy due to side effects (\n            <jats:italic>P<\/jats:italic>\n            = 0.01). The duration of oral therapy was significantly associated with relapse; after adjustment for confounders, patients receiving less than 12 weeks of oral therapy had a 5.7-fold increase of relapse or death. A combination of TMP-SMX and doxycycline is as effective as and better tolerated than the conventional four-drug regimen for the oral treatment phase of melioidosis.\n          <\/jats:p>","DOI":"10.1128\/aac.49.10.4020-4025.2005","type":"journal-article","created":{"date-parts":[[2005,9,27]],"date-time":"2005-09-27T16:28:08Z","timestamp":1127838488000},"page":"4020-4025","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":75,"title":["Open-Label Randomized Trial of Oral Trimethoprim-Sulfamethoxazole, Doxycycline, and Chloramphenicol Compared with Trimethoprim-Sulfamethoxazole and Doxycycline for Maintenance Therapy of Melioidosis"],"prefix":"10.1128","volume":"49","author":[{"given":"Wipada","family":"Chaowagul","sequence":"first","affiliation":[{"name":"Medical Department, Sappasithiprasong Hospital, Ubon Ratchathani"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wirongrong","family":"Chierakul","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Simpson","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"},{"name":"Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford OX3 7LJ, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Short","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"},{"name":"Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford OX3 7LJ, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasia","family":"Stepniewska","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"},{"name":"Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford OX3 7LJ, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bina","family":"Maharjan","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adul","family":"Rajchanuvong","sequence":"additional","affiliation":[{"name":"Medical Department, Sappasithiprasong Hospital, Ubon Ratchathani"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duangkaew","family":"Busarawong","sequence":"additional","affiliation":[{"name":"Medical Department, Sappasithiprasong Hospital, Ubon Ratchathani"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Direk","family":"Limmathurotsakul","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen C.","family":"Cheng","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"},{"name":"Menzies School of Health Research, Charles Darwin University and Northern Territory Clinical School, Flinders University, Darwin, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanaporn","family":"Wuthiekanun","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul N.","family":"Newton","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"},{"name":"Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford OX3 7LJ, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"White","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"},{"name":"Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford OX3 7LJ, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas P. J.","family":"Day","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"},{"name":"Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford OX3 7LJ, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon J.","family":"Peacock","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"},{"name":"Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford OX3 7LJ, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.20.7.1183"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/159.5.890"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/168.5.1181"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-9203(97)90044-4"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1086\/520218"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2001.64.24"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1086\/318116"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-9203(00)90333-X"},{"key":"e_1_3_2_10_2","unstructured":"National Committee for Clinical Laboratory Standards. 2004. Performance standards for antimicrobial susceptibility testing; 14th informational supplement. NCCLS document M100-S14. National Committee for Clinical Laboratory Standards Wayne Pa."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-8579(02)00016-X"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0035-9203(95)90104-3"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dki151"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.49.10.4020-4025.2005","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.49.10.4020-4025.2005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T18:37:14Z","timestamp":1645468634000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/AAC.49.10.4020-4025.2005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,10]]},"references-count":12,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2005,10]]}},"alternative-id":["10.1128\/AAC.49.10.4020-4025.2005"],"URL":"https:\/\/doi.org\/10.1128\/aac.49.10.4020-4025.2005","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,10]]},"assertion":[{"value":"2005-03-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2005-07-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2005-10-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}