title: Comparative efficacy of cefixime and ampicillin-sulbactam in shigellosis in children.
abstract: Shigellosis is still an important health problem in developing and underdeveloped countries as it is resistance to commonly used antibiotics including ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol and tetracycline. Between May 1996 and October 1996, in a prospective randomized double-blind trial, cefixime was compared with ampicillin-sulbactam, both given orally for a period of 5 days, for the treatment of 80 children with acute bloody diarrhea. Forty patients were treated with a single-dose (8 mg/kg per day) of cefixime and the other 40 patients were given three doses of 100 mg/kg per day of ampicillin-sulbactam. After identification of Shigella organisms in stool specimens, nine patients in the cefixime receiving group and six patients in the ampicillin-sulbactam receiving group were excluded from the study. Differences in average age, sex and weight between the cefixime and ampicillin-sulbactam group were statistically meaningless (P > 0.05). Fever and bloody diarrhea were universal features. The efficacy of cefixime was found to be better than ampicillin-sulbactam. Patients given cefixime had a shorter duration of fever (P < 0.01), shorter duration to disappearance of blood in the stool (P < 0.01), reduced time with diarrhea (P < 0.01) and reduced hospitalization time during the 5 study days (P < 0.01) than patients given ampicillin-sulbactam. No adverse effects were observed in the two study groups. This controlled trial showed good efficacy with cefixime compared to ampicillin-sulbactam in the treatment of shigellosis. Single-dose daily oral therapy with cefixime also showed good tolerability. Cefixime should be considered as an alternative drug of choice for shigellosis in children.
authors.affiliation: Department of Pediatrics, SSK Tepecik Teaching Hospital, Izmir, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Helvaci
authors.forename: D
authors.initials: D
authors.lastname: Bektaşlar
authors.forename: B
authors.initials: B
authors.lastname: Ozkaya
authors.forename: I
authors.initials: I
authors.lastname: Yaprak
authors.forename: B
authors.initials: B
authors.lastname: Umurtak
authors.forename: A
authors.initials: A
authors.lastname: Ertuğrul
mesh_terms: D000293:Adolescent; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D020682:Cefixime; D002439:Cefotaxime / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004405:Dysentery, Bacillary / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D013407:Sulbactam / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; C035444:sultamicillin; D000667:Ampicillin; D020682:Cefixime; D002439:Cefotaxime; D013407:Sulbactam