Treatment of bacillary dysentery in Vietnamese children: two doses of ofloxacin versus 5-days nalidixic acid.
Nalidixic acid (NA: 55 mg/kg daily for 5 days) is the recommended treatment for uncomplicated bacillary dysentery in areas where multidrug-resistant Shigella are prevalent. An open randomized comparison of this NA regimen with 2 doses of ofloxacin (total 15 mg/kg) was conducted in 1995/96 in 135 Vietnamese children with fever and bloody diarrhoea. Sixty-six children with a bacterial pathogen isolated were eligible for analysis. Of the 63 Shigella isolates, 39 (62%) were resistant to multiple antibiotics. Resolution times for fever and diarrhoea were similar in the 2 groups, but excretion time of stool pathogen was significantly longer in the NA recipients [median (range) days 1 (1-9) vs 1 (1-2), P = 0.001]. There were 9 (25%) treatment failures in the NA regimen and 3 (10%) in the ofloxacin group; P = 0.1. Two patients had NA-resistant Shigella flexneri. One of these isolates was selected during NA treatment. From a clinical and public health standpoint a 2-dose regimen of ofloxacin is preferable to nalidixic acid in the treatment of bacillary dysentery.
Vinh
H
H
Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.
Wain
J
J
Chinh
M T
MT
Tam
C T
CT
Trang
P T
PT
Nga
D
D
Echeverria
P
P
Diep
T S
TS
White
N J
NJ
Parry
C M
CM
D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004405:Dysentery, Bacillary / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007223:Infant; D009268:Nalidixic Acid / Q000627:therapeutic use*; D015242:Ofloxacin / Q000627:therapeutic use*; D012763:Shigella flexneri / Q000302:isolation & purification*; D012764:Shigella sonnei / Q000302:isolation & purification*; D016019:Survival Analysis; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D009268:Nalidixic Acid; D015242:Ofloxacin