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Mecillinam in enteric fever.

B K Mandal, A G Ironside, J Brennand

    British Medical Journal
    |March 3, 1979
    PubMed
    Summary
    This summary is machine-generated.

    Mecillinam treatment for enteric fever was ineffective for most patients, with many requiring a switch to chloramphenicol for symptom resolution. This study questions mecillinam

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    Area of Science:

    • Infectious Diseases
    • Clinical Pharmacology
    • Microbiology

    Background:

    • Enteric fever, a systemic infection caused by Salmonella species, poses a significant global health challenge.
    • Antibiotic resistance is a growing concern, necessitating evaluation of alternative treatment options.
    • Mecillinam, a beta-lactam antibiotic, has shown in vitro activity against Salmonella, prompting clinical investigation.

    Purpose of the Study:

    • To evaluate the clinical efficacy and safety of mecillinam as a primary treatment for enteric fever.
    • To compare the treatment outcomes of mecillinam versus chloramphenicol in patients with enteric fever.

    Main Methods:

    • A prospective trial involving twelve consecutive patients diagnosed with enteric fever.
    • Patients received a 14-day course of mecillinam.

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  • Treatment response was monitored by fever resolution, and patients were switched to chloramphenicol if symptoms persisted.

    • Main Results:

    • Only three out of twelve patients achieved afebrile status within three days of mecillinam treatment.
    • Four patients showed no improvement, necessitating a change to chloramphenicol, which yielded positive results.
    • One patient experienced a clinical relapse five days after fever resolution on day 13.

    Conclusions:

    • Mecillinam is not an effective or consistent treatment for enteric fever, despite in vitro sensitivity of recovered organisms.
    • Chloramphenicol demonstrated superior efficacy in managing persistent or relapsed cases of enteric fever.
    • Further research is warranted to explore alternative therapeutic strategies for enteric fever management.