A pilot, single-centre, randomised control trial to determine if intensive phase antibiotics alone (intravenous antibiotics for 14 to 42 days) will result in the same clinical outcomes as standard antibiotics (intensive phase antibiotics plus eradication phase antibiotics (90 days of oral antibiotics)) in adults with melioidosis.

All treatment will occur at Cairns Hospital (either within the hospital or through the hospital in the home service) or at a regional hospital in Far North Queensland if a person requires on going non-tertiary level hospital care. Short course therapy: Intravenous meropenem or ceftazidime, chosen at the discretion of the treating clinician, adjusted for renal function and dosed in accordance with the Australian Therapeutic Guidelines for 14 to 42 days as determined by the treating infectious diseases clinician. The duration of intravenous phase will be determined by the antibiotic duration determining focus and the treating clinician will be encouraged to follow the 2020 Revised Darwin melioidosis guideline. Intravenous meropenem will be dosed at 1-2g three times per day, adjusted for renal function as determined by the treating clinician. Intravenous ceftazidime will be dosed at 2g four times a day, adjusted for renal function as determined by the treating clinician. For the purposes of outpatient parenteral antibiotic therapy, ceftazidime at a dose of 8g daily, adjusted for renal function as determined by the treating clinician, will be administered as a 24-hour intravenous infusion using an elastometric infusion device. To help ensure adherence, the elastometric infusion device will be administered and removed daily by a nurse trained in the use of elastometric devices. No eradication phase therapy will be given.