Serum bactericidal and inhibitory titres in the management of melioidosis

A retrospective evaluation of the relationship between serum bactericidal a nd inhibitory titres and treatment outcome in 195 adult Thai patients with severe melioidosis was conducted. Drug regimens included ceftazidime (52% o f patients), co-amoxiclav (24%), imipenem (11%) or the conventional four-dr ug combination (11%). Pre- and 1 h post-dose serum samples were collected a fter 48-72 h of therapy, and serum inhibitory and bactericidal titrations d etermined. Median post-dose titres were: bactericidal 1:8 (range 0-1:128) a nd inhibitory 1:16 (range 0-1:128). Overall mortality was 26% and outcome w as not influenced by either inhibitory or bactericidal titres. Pre-dose tit res correlated with renal function; renal function was the most important p redictor of mortality. Determination of serum inhibitory or bactericidal ti tres is unhelpful in the management of severe melioidosis.