Norfloxacin in the treatment of bacterial enteric infections

Diarrhoeal diseases are a major cause of illness and death among infants and young children, especially in developing countries. They are also the principal cause of illness in tourists who travel to these countries. Overall, the main causes of diarrhoea are bacterial. Campylobacter, enteropathogenic E. coli, shigella and enterotoxigenic E. coli are, in this order, the most common bacterial enteropathogens isolated in developing countries, and campylobacter and shigella in developed countries. Even though the cornerstone of the treatment of diarrhoea is oral rehydration, especially in children, the better knowledge of the pathogens involved and the mechanisms by which these organisms produce diarrhoea has brought the reconsideration of antibiotic use, which just a few years ago was considered unnecessary except for shigella. The increasing number of shigella and Salmonella typhi resistant to ampicillin and co-trimoxazole and the recognition of campylobacter, an enteropathogen normally resistant to these drugs as a major cause of diarrhoea, makes it necessary to investigate new agents against these three enteropathogens. Antimicrobial susceptibility studies done in Mexico and other parts of the world have shown that norfloxacin, a new quinolone, is very active against multi-resistant S. typhi and shigella and against campylobacter, with MIC values of approximately 0.8 mg/l. Furthermore, it achieves high concentrations in faeces after oral administration. Clinical studies of norfloxacin used in inflammatory diarrhoea and in prophylaxis of traveller's diarrhoea have demonstrated it to be an effective and well-tolerated drug. Norfloxacin has great potential for the treatment of bacterial enteric infections reflected by its broad in vitro activity as well as its effectiveness in initial clinical trials.(ABSTRACT TRUNCATED AT 250 WORDS)