A patient with acute meliodosis may relapse following therapy. This may occur weeks, months or even years after the original infection. The risk is increased if certain factors are present.
Antibiotic therapy is usually given in 2 phases:
(1) intensive phase (for 12 to 20 weeks)
(2) eradication (or maintenance) phase (for 12 to 24 weeks)
Risk factors for relapse:
(1) poor adherence to antibiotic therapy
(2) insufficient dose of antibiotic
(3) inappropriate antibiotic for use during the intensive phase (ampicillin-clavulanate)
(4) inappropriate antibiotic for use during the eradication phase (doxycycline monotherapy, amoxicillin-clavulanate)
(5) severe disease
(6) duration of therapy too short (< 8 weeks of therapy during the eradication phase)
Differential diagnosis:
(1) reinfection with a different strain
To read more or access our algorithms and calculators, please log in or register.
