{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T21:22:48Z","timestamp":1789939368332,"version":"4.0.1"},"reference-count":33,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2010,4,27]],"date-time":"2010-04-27T00:00:00Z","timestamp":1272326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Melioidosis is a complex bacterial infection, treatment of which combines the urgency of treating rapidly fatal Gram negative septicaemia with the need for eradication of long-term persistent disease in pulmonary, soft tissue, skeletal and other organ systems. Incremental improvements in treatment have been made as a result of multicentre collaboration across the main endemic region of Southeast Asia and northern Australia. There is an emerging consensus on the three main patterns of antimicrobial chemotherapy; initial (Phase 1) treatment, subsequent eradication (Phase 2) therapy and most recently post-exposure (Phase 0) prophylaxis. The combination of agents used, duration of therapy and need for adjunct modalities depends on the type, severity and antimicrobial susceptibility of infection. New antibiotic and adjunct therapies are at an investigational stage but on currently available data are unlikely to make a significant impact on this potentially fatal infection.<\/jats:p>","DOI":"10.3390\/ph3051296","type":"journal-article","created":{"date-parts":[[2010,4,27]],"date-time":"2010-04-27T11:18:19Z","timestamp":1272367099000},"page":"1296-1303","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["The Treatment of Melioidosis"],"prefix":"10.3390","volume":"3","author":[{"given":"Timothy J.J.","family":"Inglis","sequence":"first","affiliation":[{"name":"Division of Microbiology & Infectious Diseases, PathWest Laboratory Medicine WA, QEII Medical Centre, Nedlands, WA 6009, Australia"},{"name":"Microbiology & Immunology, School of Biomedical, Biomolecular and Chemical Sciences, Faculty of Life & Applied Sciences, University of Western Australia, Crawley, WA 6009, Australia"},{"name":"School of Pathology and Laboratory Medicine, Faculty of Medicine & Dentistry, University of Western Australia, Crawley, WA 6009, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2010,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1586\/14787210.4.3.445","article-title":"Management of melioidosis","volume":"4","author":"Wuthiekanun","year":"2006","journal-title":"Exp. Rev. Anti-Infect. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/S0036-46652006000100001","article-title":"Clinical guideline for diagnosis and management of melioidosis","volume":"48","author":"Inglis","year":"2006","journal-title":"Rev. Inst. Med. Trop. S\u00e3o Paulo"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1128\/CMR.18.2.383-416.2005","article-title":"Melioidosis: epidemiology, pathophysiology, and management","volume":"18","author":"Cheng","year":"2005","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1093\/jac\/dkg011","article-title":"A comparison of antibiotic regimens in the treatment of acute melioidosis in a mouse model","volume":"51","author":"Ulett","year":"2003","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1086\/520219","article-title":"Comparison of imipenem and ceftazidime as therapy for severe melioidosis","volume":"29","author":"Simpson","year":"1999","journal-title":"Clin. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1128\/AAC.48.5.1763-1765.2004","article-title":"Outcomes of patients with melioidosis treated with meropenem","volume":"48","author":"Cheng","year":"2004","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2999","DOI":"10.1128\/AAC.48.8.2999-3005.2004","article-title":"Comparison of the susceptibilities of Burkholderia pseudomallei to meropenem and ceftazidime by conventional and intracellular methods","volume":"48","author":"Inglis","year":"2004","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/S0924-8579(00)00334-4","article-title":"Antibiotic susceptibility of Burkholderia pseudomallei from tropical northern Australia and implications for therapy of melioidosis","volume":"17","author":"Jenney","year":"2001","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1111\/j.1365-3156.2004.01244.x","article-title":"Out of hospital treatment of patients with melioidosis using ceftazidime in 24 h elastomeric infusors, via peripherally inserted central catheters","volume":"9","author":"Huffam","year":"2004","journal-title":"Trop. Med. Int. Health."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1086\/520010","article-title":"Addition of trimethoprim-sulfamethoxazole to ceftazidime during parenteral treatment of melioidosis is not associated with a long-term outcome benefit","volume":"45","author":"Chierakul","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"76","DOI":"10.4269\/ajtmh.2001.65.76","article-title":"Case report: recovery from persistent septicemi cmelioidosis","volume":"65","author":"Inglis","year":"2001","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1093\/infdis\/168.5.1181","article-title":"Relapse in melioidosis: incidence and risk factors","volume":"168","author":"Chaowagul","year":"1993","journal-title":"J. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4020","DOI":"10.1128\/AAC.49.10.4020-4025.2005","article-title":"Open-label randomized trial of oral trimethoprim-sulfamethoxazole, doxycycline, and chloramphenicol compared with trimethoprim-sulfamethoxazole and doxycycline for maintenance therapy of melioidosis","volume":"49","author":"Chaowagul","year":"2005","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1093\/jac\/dkl389","article-title":"Pharmacokinetic and pharmacodynamic assessment of co-amoxiclav in the treatment of melioidosis","volume":"58","author":"Chierakul","year":"2006","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"208","DOI":"10.4269\/ajtmh.2008.78.208","article-title":"Consensus guidelines for dosing of amoxicillin-clavulanate in melioidosis","volume":"78","author":"Cheng","year":"2008","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"6032","DOI":"10.1128\/JCM.43.12.6032-6034.2005","article-title":"Recurrent melioidosis in patients in northeast Thailand is frequently due to reinfection rather than relapse","volume":"43","author":"Maharjan","year":"2005","journal-title":"J. Clin. Microbiol."},{"key":"ref_17","first-page":"27","article-title":"Pahang melioidosis registry","volume":"64","author":"How","year":"2009","journal-title":"Med. J. Malays."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1086\/507632","article-title":"Risk factors for recurrent melioidosis in northeast Thailand","volume":"43","author":"Limmathurotsakul","year":"2006","journal-title":"Clin. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e327","DOI":"10.1371\/journal.pntd.0000327","article-title":"A simple scoring system to differentiate between relapse and re-infection in patients with recurrent melioidosis","volume":"2","author":"Limmathurotsakul","year":"2008","journal-title":"Pub. Lib. Sci. Negl. Trop. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1046\/j.1445-5994.2002.00195.x","article-title":"An audit of the use of granulocyte colony-stimulating factor in septic shock","volume":"32","author":"Stephens","year":"2002","journal-title":"Intern. Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1086\/519261","article-title":"A randomized controlled trial of granulocyte colony-stimulating factor for the treatment of severe sepsis due to melioidosis in Thailand","volume":"45","author":"Cheng","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_22","first-page":"83","article-title":"Successful treatment of life-threatening melioidosis with activated protein C and meropenem","volume":"40","author":"Tan","year":"2007","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1111\/j.1553-2712.2009.00350.x","article-title":"Statin therapy is associated with decreased mortality in patients with infection","volume":"16","author":"Donnino","year":"2009","journal-title":"Acad. Emerg. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/j.1469-0691.2009.02750.x","article-title":"Statins for sepsis: a critical and updated review","volume":"15","author":"Kopterides","year":"2009","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"151","DOI":"10.4269\/ajtmh.1992.46.151","article-title":"Serial serum C-reactive protein levels as an aid to the management of melioidosis","volume":"46","author":"Ashdown","year":"1992","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"580","DOI":"10.4269\/ajtmh.2004.70.580","article-title":"C-reactive protein in the diagnosis of melioidosis","volume":"70","author":"Cheng","year":"2004","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/S0755-4982(05)83900-4","article-title":"Glanders, melioidosis and biowarfare","volume":"34","author":"Guilhot","year":"2005","journal-title":"Presse Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1056\/NEJM198111053051907","article-title":"Laboratory-acquired infection with Pseudomonas pseudomallei (melioidosis)","volume":"305","author":"Schlech","year":"1981","journal-title":"New Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"56","DOI":"10.3201\/eid0601.000110","article-title":"Burkholderia pseudomallei traced to water treatment plant in Australia","volume":"6","author":"Inglis","year":"2000","journal-title":"Emerg. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.3201\/eid1407.071501","article-title":"Management of accidental laboratory exposure to Burkholderia pseudomallei and B mallei.","volume":"14","author":"Peacock","year":"2008","journal-title":"Emerg. Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1093\/jac\/dkm527","article-title":"Pre- and post-exposure prophylaxis of experimental Burkholderia pseudomallei infection with doxycycline, amoxicillin\/clavulanic acid and co-trimoxazole","volume":"61","author":"Sivalingam","year":"2008","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3115","DOI":"10.1128\/AAC.00893-08","article-title":"In vitro activity of doripenem against Burkholderia pseudomallei","volume":"53","author":"Thamlikitkul","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1093\/jac\/dkm488","article-title":"In vitro activity of ceftobiprole against Burkholderia pseudomallei","volume":"61","author":"Thamlikitkul","year":"2008","journal-title":"J. Antimicrob. Chemother."}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/3\/5\/1296\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T22:02:16Z","timestamp":1760220136000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/3\/5\/1296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,4,27]]},"references-count":33,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2010,5]]}},"alternative-id":["ph3051296"],"URL":"https:\/\/doi.org\/10.3390\/ph3051296","relation":{},"ISSN":["1424-8247"],"issn-type":[{"value":"1424-8247","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,4,27]]}}}