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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
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[Antibiotic treatment of acute gastroenteritis]

F Segura Porta1, A Moreno, G Serrate

  • 1Programa Asistencial de Enfermedades Infecciosas, Consorci Hospitalari del Parc Taulí, Sabadell.

Revista Clinica Espanola
|April 1, 1997
PubMed

Insights

Empiric antibiotic therapy for acute gastroenteritis (AGE) is reserved for high-risk patients. Both pivmecillinam and ciprofloxacin demonstrated similar efficacy in treating AGE and reducing Salmonella spp. fecal shedding.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Acute gastroenteritis (AGE) treatment guidelines recommend empiric antibiotics only for patients with specific risk factors.
  • Salmonella spp. is a common pathogen in AGE, with potential for bacteremia and fecal carriage.

Purpose of the Study:

  • To evaluate the clinical characteristics and efficacy of pivmecillinam versus ciprofloxacin in adult patients with AGE requiring antibiotic therapy.
  • To assess the impact of these antibiotics on the fecal carrier state of Salmonella spp.

Main Methods:

  • A study involving 127 adult patients with AGE and indications for antibiotic therapy.
  • Patients received either pivmecillinam (52) or ciprofloxacin (75).
  • Clinical outcomes and fecal shedding of Salmonella spp. were monitored.

Main Results:

  • Initial stool cultures were positive in 71% of patients, with Salmonella spp. being the most frequent isolate.
  • Salmonella spp. showed 100% susceptibility to ciprofloxacin and 90% to mecillinam.
  • Both pivmecillinam and ciprofloxacin therapies exhibited comparable clinical efficiency.
  • Fecal excretion of Salmonella spp. did not exceed five weeks, and no chronic carriers were identified.

Conclusions:

  • Pivmecillinam and ciprofloxacin are effective in treating acute gastroenteritis in indicated patients.
  • Antibiotic therapy effectively reduces the duration of fecal shedding of Salmonella spp., preventing chronic carriage.

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