Opções Terapêuticas para Melioidose: Uma Revisão Sistemática

Introduction: Melioidosis is a disease caused by the bacterium Burkholderia pseudomallei, common in tropical regions. It is poorly understood and studied by health professionals, but some antibiotics reduce mortality from infection by 50%. Method: This review aimed to evaluate the quality of the literature on basic information characteristic of melioidosis by comparing the diagnostic methods and medications used according to the PRISMA guidelines. The inclusion criteria were individuals infected with the bacterium Burkholderia pseudomallei, and the exclusion criteria were individuals under 3 years of age and over 70 years of age. Results: Immunochromatography assay results were insensitive. PCR use can reduce the time to a definitive diagnosis by up to 36 hours. API 20NE and 20E identified 98% and 99% of B. pseudomallei isolates, respectively. AKI, advanced age, or DM did not worsen mortality. Treatment with ceftazidime was associated with good activity compared to conventional therapy. In severe sepsis, meropenem resulted in lower mortality than ceftazidime. Hepatic and bacteremic comorbidities had a worse prognosis. Treatment with ceftazidime, meropenem, TMP-SMX plus doxycycline is therapeutic in non-septicemia. Doxycycline alone is not recommended as treatment of choice. Conclusion: Through comparative research, the culture method remains the preferred method for investigation, despite the time it takes to produce results. Regarding treatment, the medication evaluated as first-line is ceftazidime.