March 23rd, 2018

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Melioidosis in Pregnancy
Authors:  Andrew R. Orr, B.S., and Mark Martens, M.D.
  Bacterial melioidosis is a frequently devastating opportunistic infection caused by the environmental organism Burkholderia pseudomallei. In an era where global travel allows for the spread of melioidosis and other dangerous illnesses beyond their traditionally endemic areas, international treatment protocols have gained additional significance; however, treatment guidelines for melioidosis in pregnancy remain unclear. Given the potential for increasing incidence of the infection globally and the classification of B. pseudomallei as a Category B bioterrorism agent, this article seeks to determine the projected clinical course and optimal treatment of melioidosis infection during pregnancy. A review of the literature suggests that early administration of intravenous ceftazidime at a dose of 50 mg/kg (up to 2 g) every 6–8 hours for 10–14 days followed by an 8–20-week course of oral amoxicillin/clavulanate for eradication therapy defines optimal therapy once a diagnosis of melioidosis is suspected in a pregnant patient.
Keywords:  bioterrorism, Burkholderia pseudomallei, melioidosis, pregnancy, Pseudomonas pseudomallei, sepsis
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