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Pivampicillin/pivmecillinam in the treatment of shigella carriers
1Department of Infectious Diseases, Roslagstull Hospital, Karolinska Institute, Stockholm, Sweden.
Abstract:
24 patients (4-65 years old; median age 29 years) excreting shigella bacteria greater than 8 weeks were treated with the combination pivampicillin (0.25 g)/pivmecillinam (0.20 g), 2 tablets 3 times a day for 14 days. 23/24 patients (96%) were culture negative after treatment. The one patient that did not respond to treatment carried a strain with intermediate sensitivity to mecillinam and resistance to ampicillin. It is concluded that pivampicillin/pivmecillinam is effective for patients excreting shigella bacteria.
Insights
This study found that a combination of pivampicillin and pivmecillinam effectively treated chronic shigella infections in 96% of patients. This antibiotic combination offers a promising solution for persistent shigella bacteria.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Chronic shigella infections pose a significant health challenge, often requiring prolonged treatment.
- Antibiotic resistance in shigella strains necessitates the exploration of effective therapeutic options.
Purpose of the Study:
- To evaluate the efficacy of a pivampicillin/pivmecillinam combination in treating patients with chronic shigella excretion.
- To assess the microbiological cure rate and identify potential resistance patterns.
Main Methods:
- A cohort of 24 patients with shigella bacteria excretion exceeding 8 weeks was enrolled.
- Patients received pivampicillin (0.25 g) / pivmecillinam (0.20 g) tablets, 2 tablets three times daily for 14 days.
- Post-treatment cultures were performed to assess bacterial eradication.
Main Results:
- A high microbiological cure rate of 96% (23/24 patients) was achieved.
- One patient with intermediate mecillinam sensitivity and ampicillin resistance did not respond to treatment.
- The treatment was generally well-tolerated, leading to negative cultures post-therapy.
Conclusions:
- Pivampicillin/pivmecillinam combination therapy demonstrates significant efficacy in clearing chronic shigella infections.
- This antibiotic regimen is a viable treatment option for patients with persistent shigella bacteria.
- Monitoring for antibiotic sensitivity is crucial, especially in cases of treatment failure.