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Related Experiment Videos

Current problems in antimicrobial therapy for bacterial enteric infection.

H L DuPont, C D Ericsson, A Robinson

    The American Journal of Medicine
    |April 27, 1987
    PubMed
    Summary

    Ciprofloxacin is effective for bacterial diarrhea, including against resistant strains. It offers a valuable alternative to trimethoprim/sulfamethoxazole, especially where resistance is common.

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    Area of Science:

    • Microbiology
    • Infectious Diseases
    • Pharmacology

    Background:

    • Trimethoprim/sulfamethoxazole is a primary treatment for shigellosis and travelers' diarrhea.
    • Increasing resistance to trimethoprim/sulfamethoxazole in enteric pathogens limits its efficacy.
    • Campylobacter jejuni and other enteropathogens exhibit resistance to this combination therapy.

    Purpose of the Study:

    • To evaluate the in vitro susceptibility of enteric bacterial pathogens to ciprofloxacin.
    • To compare the clinical efficacy of ciprofloxacin versus trimethoprim/sulfamethoxazole in treating bacterial diarrhea.
    • To assess the effectiveness of these antibiotics against various enteropathogens.

    Main Methods:

    • In vitro susceptibility testing of 210 bacterial enteropathogens to determine minimal inhibitory concentrations (MICs).

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  • A clinical trial involving a student population with diarrhea acquired in Mexico.
  • Comparison of treatment outcomes (duration of diarrhea) between ciprofloxacin, trimethoprim/sulfamethoxazole, and placebo groups.

    • Main Results:

    • Ciprofloxacin demonstrated low MICs against a range of enteropathogens, including C. jejuni, E. coli, Salmonella, and Shigella.
    • Both ciprofloxacin and trimethoprim/sulfamethoxazole were significantly more effective than placebo in reducing diarrhea duration (29 and 20 hours vs. 81 hours, respectively).
    • Antimicrobial treatment was efficacious against enterotoxigenic E. coli, invasive enteropathogens, and unknown pathogens.

    Conclusions:

    • Ciprofloxacin is a viable and effective treatment for acute bacterial diarrhea, particularly in regions with high rates of trimethoprim/sulfamethoxazole resistance.
    • Quinolone derivatives like ciprofloxacin are well-suited for treating bacterial diarrhea where C. jejuni is prevalent and resistance is a concern.
    • Ciprofloxacin provides an effective therapeutic option, addressing limitations of traditional treatments.