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April 8, 1968

Treatment of Melioidosis

Author Affiliations

Tacoma, Wash

JAMA. 1968;204(2):176. doi:10.1001/jama.1968.03140150080029

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To the Editor:—  In an article entitled "Melioidosis," I discussed treatment of this disease (200:452, 1967). Because of the potential bone marrow, hepatic, renal, and eighth nerve toxicity of the high dosages of chloramphenicol, kanamycin sulfate, and sodium novobiocin sodium recommended as therapy for the severe unresponsive form of the disease, I wish to emphasize the indications and contraindications for this regimen.Melioidosis, like most infectious diseases, causes a spectrum of clinical manifestations ranging from inapparent disease to overwhelming infection, depending upon the virulence of the strain and host resistance. As with most gram-negative organisms, antibiotic susceptibility is quite variable. Therefore, therapy must be determined by two factors; the seriousness of the infection and the antibiotic sensitivity of the specific strain of Pseudomonas pseudomallei involved.It is of importance to realize that the majority of infections can be handled with tetracycline or chloramphenicol therapy in doses of 2 to