Postexposure Antimicrobial Drug Therapy in Goats Infected with Burkholderia pseudomallei

Abstract

Infection with Burkholderia pseudomallei, the causative agent of melioidosis, occurs by exposure to the organism in soil or water. There is concern for B. pseudomallei use as a potential bioweapon and as an exposure hazard in diagnostic laboratories processing samples or cultures containing the bacterium. The optimal strategies for treatment and postexposure prophylaxis are inadequately developed. This study used goats to evaluate 3 antimicrobial drug treatment regimens for postexposure therapy because they are a species naturally susceptible to B. pseudomallei infection. Goats were infected by percutaneous inoculation, and antimicrobial drug therapies were initiated 48 hours later. Widespread infection with abscess formation in multiple organs developed in untreated goats and goats treated with either amoxicillin/clavulanate or sulfamethoxazole/trimethoprim. In contrast, treatment with the combination of all 4 antimicrobial drugs might have eradicated the infection. Our findings suggest combination therapy with those 4 antimicrobial drugs may be useful for postexposure prophylaxis in humans.