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Attempted prevention of diarrheal disease in Apache children with a non-absorbable broad-spectrum antimicrobial
Insights
Oral colistin sulfate, an antimicrobial, increased diarrhea in infants but slightly reduced it in toddlers. Enteropathogenic E. coli was more common in treated well children, with no impact on growth.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Public health
Background:
- Acute diarrhea is a significant health concern in young children, particularly in indigenous populations.
- The prophylactic use of antimicrobials for preventing childhood diarrhea is a subject of ongoing research.
- Understanding the impact of broad-spectrum antimicrobials on gut microbiota and disease incidence is crucial.
Purpose of the Study:
- To evaluate the prophylactic efficacy of oral colistin sulfate against acute diarrhea in Apache children.
- To assess the effect of colistin sulfate on the incidence of diarrhea in different age groups of children.
- To investigate the relationship between antimicrobial use, enteropathogen isolation, and child growth.
Main Methods:
- A double-blind, placebo-controlled study design was employed.
- Participants included Apache children aged 1 to 30 months.
- Oral colistin sulfate was administered as a prophylactic agent, with outcomes compared to a placebo group.
Main Results:
- Infants (1-6 months) receiving colistin sulfate experienced more than double the diarrhea morbidity compared to placebo.
- Toddlers (7-30 months) showed a slight reduction in diarrhea incidence with colistin sulfate treatment.
- Enteropathogenic E. coli was isolated more frequently from well children in the antimicrobial group; no significant effect on child growth was observed.
Conclusions:
- Oral colistin sulfate demonstrated a detrimental effect on diarrhea prevention in infants, increasing morbidity.
- The antimicrobial showed a modest benefit in reducing diarrhea in older children (toddlers).
- The study highlights age-specific differential effects of antimicrobials on childhood diarrhea and gut flora.
Abstract:
A double-blind study was conducted to test the prophylactic effect of a non-absorbable broad-spectrum antimicrobial (oral colistin sulfate) against acute diarrhea in Apache children. Children 1 to 6 months old had over twice the morbidity from diarrhea if assigned to the antimicrobial group as compared to placebo, while the toddler group (7-30 months) taking the antimicrobial had somewhat less diarrhea. Enteropathogenic E. coli were significantly more often isolated from the antimicrobial group (but only in well children). No special effect on the children's growth by the antimicrobial was discerned.