The first line drug for the initial intensive therapy of meliodosis is ceftazidime. Therapy should be switched to meropenem under certain circumstances.
Indications to switch to meropenem:
(1) The patient deteriorates during ceftazidime therapy.
(2) A new focus of infection develops.
(3) A repeat blood culture at 7 days of ceftazidime therapy is still positive.
Dose: 25 mg/kg, maximum dose 1 gram
Frequency: every 8 hours
Route: intravenous (IV)
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