Factors Associated with Failure of Treatment for Melioidosis in Phen Hospital, Udonthani
Keywords:
Melioidosis, Failure of treatmentAbstract
Melioidosis occurs predominantly in Thailand, especially in Northeastern Thailand. Failure of treatment for melioidosis occurs several times despite adequate antibiotic treatment. The aim of this study was to find out the factors associated with failure of treatment for melioidosis. The study was a single hospital retrospective descriptive study collecting the data of melioidosis patients who had evidence of microbiological diagnosis between October 2016 and September 2020 in-patient department at Phen hospital, Udonthani. Divided into 2 groups; failure of treatment group and success or favor-outcome group. Data were collected from medical record then logistic regression was used to analyses to find out those factors.
Result: Between the time of the study 97 patients were diagnosed melioidosis base on diagnostic microbiology. Four patients were died and Two of them were died less than 48 hours after treatment and were excluded from the study. The rest 95 patients were included in the study, 65.3% of patients were male. Pneumonia, septic shock and inappropriate antibiotic factors were found in Failure of treatment group higher than success group (58.1 vs 9.6, 41.9% vs 15.4% and 11.6% vs 0.0% respectively) these were higher significantly (p<0.001, p=0.004 and p =0.017 respectively) And antibiotic ceftazidime treatment in failure group less than success group (76.7% vs 92.3%, p=0.033). There were no statistical significant differences between both groups in factors underlying diseases nor septicemia between both groups.
multivariate analysis, revealed independent predictor failure of treatment with statistically significant were pneumonia, osteoarthritis/septic arthritis, intra-abdominal abscess and septic shock prior to admission with Adjusted odd ratio 23.99 (95%CI 7.17-235.68 p < 0.001), 23.76 (95%CI 3.34-169.04, p = 0.002), 14.05 (95%CI 2.19-89.96, p = 0.005) and 8.38, 95%CI 2.04-34.40, p = 0.003) respectively
Conclusion: Factors associated with failure of treatment for melioidosis were pneumonia, osteomyelitis/septic arthritis, intra-abdominal abscess and septic shock prior to admission
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