Novel approach in treatment of Burkholderia pseudomallei osteomyelitis: salvage therapy with levonadifloxacin

Levonadifloxacin emerged as the salvage therapy for this patient, achieving significant clinical improvement without relapse after more than 6 months of therapy cessation, despite the life-threatening combination of melioidosis-associated osteomyelitis and antibiotic intolerance. This first reported use of levonadifloxacin in melioidosis underscores its potential as an alternative therapy in such complex infections. Aggressive surgical intervention and tailored antimicrobial strategies remain crucial to overcoming these dual challenges.