The therapy of meliodosis can be challenging. The standard treatment involves an initial intensive intravenous therapy to control the infection followed by a prolonged oral eradication therapy to prevent relapse.


Recommended drug: ceftazidime

Dose: 50 mg/kg, maximum 2,000 mg (2 g)

Route: intravenous (IV)

Frequency: every 6 to 8 hours


Clinical Status

Duration of Therapy


10 to 14 days

severe disease

28 days or more (>= 4 weeks)


Trimethoprim sulfamethoxazole may be given to patients with bone, joint, prostatic or neurologic disease.


Trimethoprim (TMP): 8 mg per kg up to 320 mg

Sulfamethoxazole (SMX): 40 mg per kg up to 1600 mg

Frequency: every 12 hours

Route: oral



• The indications for TMP-SMX are the same conditions defining severe disease, except that severe disease also involves septic shock and extensive lung disease.


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