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Melioidosis — RACP Adult Medicine MCQ

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HardInfectious diseasesMelioidosisRACP Adult Medicine

A 52-year-old with diabetes returns from the Northern Territory wet season with severe pneumonia and multiple splenic abscesses; blood culture grows Burkholderia pseudomallei. What treatment course is required?

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Correct answer: C — Use an intensive IV phase with ceftazidime or meropenem, followed by oral trimethoprim-sulfamethoxazole eradication therapy

The best answer is “Use an intensive IV phase with ceftazidime or meropenem, followed by oral trimethoprim-sulfamethoxazole eradication therapy”. Severe disseminated melioidosis requires a parenteral intensive phase—meropenem is favoured in critical illness, while ceftazidime is another established agent—then a prolonged eradication phase, usually trimethoprim-sulfamethoxazole, to prevent relapse. Short therapy and aminoglycoside monotherapy are ineffective.

Reference: Northern Territory Health: Melioidosis: https://health.nt.gov.au/health-alerts/melioidosis