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Early treatment with erythromycin of Campylobacter jejuni-associated dysentery in children
Insights
Early erythromycin treatment significantly shortens diarrhea and Campylobacter jejuni fecal excretion in children with acute dysentery. This antibiotic intervention offers a faster recovery for young patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Campylobacter jejuni infections cause acute dysentery in children.
- Prolonged diarrhea and fecal shedding pose significant health risks.
Purpose of the Study:
- To assess the efficacy of early erythromycin treatment.
- To evaluate its impact on diarrhea duration and C. jejuni fecal excretion.
Main Methods:
- Randomized, double-blind, placebo-controlled trial.
- 170 patients (3-60 months) with acute dysentery.
- Treatment with erythromycin ethyl succinate or placebo.
Main Results:
- Erythromycin significantly increased normal stools by day 2 (36% vs 0%) and day 5 (93% vs 50%).
- Fecal excretion of C. jejuni was significantly shorter in the erythromycin group.
- Treatment failure was significantly lower with erythromycin (0% vs 42%).
Conclusions:
- Early erythromycin administration is effective in treating C. jejuni-associated acute dysentery.
- It reduces both the duration of diarrhea and organism shedding.
- This intervention improves clinical outcomes in pediatric patients.
Abstract:
To evaluate the efficacy of early treatment with erythromycin on the duration of fecal excretion and of diarrhea associated with Campylobacter jejuni, 170 patients, age 3 to 60 months, were randomly assigned in a double-blind fashion to receive either erythromycin ethyl succinate or placebo immediately after being seen at Cayetano Heredia Hospital because of acute dysentery. The groups' pretreatment characteristics were comparable. Of the 30 patients with stools positive for C. jejuni, 12 were in the placebo group and 16 in the treatment group. After 2 days of treatment, none of the patients in the placebo group and 36% of those in the erythromycin group had normal stools (P less than 0.05). After 5 days of treatment, 50% of the patients in the placebo group and 93% of those in the erythromycin group had normal stools (P less than 0.02). Fecal excretion of the organism continued significantly longer in the placebo group (P less than 0.01). There were no treatment failures in the treatment group compared with five (42%) in the placebo group (P less than 0.01). Thus, early administration of erythromycin significantly reduced the duration of both diarrhea and fecal excretion of the organism in infants and children with acute dysentery associated with C. jejuni.