TY - JOUR
T1 - Comparison of single-dose treatment with norfloxacin and standard 5-day treatment with trimethoprim-sulfamethoxazole for acute Shigellosis in adults
AU - Gotuzzo, E.
AU - Oberhelman, R. A.
AU - Maguina, C.
AU - Berry, S. J.
AU - Yi, A.
AU - Guzman, M.
AU - Ruiz, R.
AU - Leon-Barua, R.
AU - Sack, R. B.
PY - 1989
Y1 - 1989
N2 - Shigellae have been shown to be highly susceptible to new quinolone agents, with average MICs for 90% of isolates of < 0.1 μg/ml. Because these agents also reach high concentrations in the stool after a single dose, the effectiveness of a single 800-mg dose of norfloxacin and of 5-day treatment with trimethoprim-sulfamethoxazole (TMP-SMX) were compared in a randomized trial. Patients with clinical dysentery received one of the these treatment regimens, and clinical data and follow-up culture results were analyzed for patients whose stool culture on presentation grew shigellae. When 55 patients with shigellosis (26 treated with TMP-SMX, 29 treated with norfloxacin) whose bacterial isolates were susceptible to the antibiotic given were compared by treatment group, no significant differences were seen in days of illness (mean, 2.5 ± 0.65 days with TMP-SMX and 2.0 ± 0.47 days with norfloxacin; P = 0.200) or number of unformed stools after starting treatment (mean, 9.7 ± 2.37 stools with TMP-SMX and 7.6 ± 3.19 stools with norfloxacin; P = 0.312). Resistance in vitro to TMP-SMX was seen in 15% of Shigella isolates, whereas none was resistant to norfloxacin. Bacteriologic failure was found in 1 patient among 24 receiving TMP-SMX and in none of 25 patients receiving norfloxacin. One single dose of norfloxacin was as effective as 5 days of treatment with TMP-SMX in these adults with shigellosis.
AB - Shigellae have been shown to be highly susceptible to new quinolone agents, with average MICs for 90% of isolates of < 0.1 μg/ml. Because these agents also reach high concentrations in the stool after a single dose, the effectiveness of a single 800-mg dose of norfloxacin and of 5-day treatment with trimethoprim-sulfamethoxazole (TMP-SMX) were compared in a randomized trial. Patients with clinical dysentery received one of the these treatment regimens, and clinical data and follow-up culture results were analyzed for patients whose stool culture on presentation grew shigellae. When 55 patients with shigellosis (26 treated with TMP-SMX, 29 treated with norfloxacin) whose bacterial isolates were susceptible to the antibiotic given were compared by treatment group, no significant differences were seen in days of illness (mean, 2.5 ± 0.65 days with TMP-SMX and 2.0 ± 0.47 days with norfloxacin; P = 0.200) or number of unformed stools after starting treatment (mean, 9.7 ± 2.37 stools with TMP-SMX and 7.6 ± 3.19 stools with norfloxacin; P = 0.312). Resistance in vitro to TMP-SMX was seen in 15% of Shigella isolates, whereas none was resistant to norfloxacin. Bacteriologic failure was found in 1 patient among 24 receiving TMP-SMX and in none of 25 patients receiving norfloxacin. One single dose of norfloxacin was as effective as 5 days of treatment with TMP-SMX in these adults with shigellosis.
UR - http://www.scopus.com/inward/record.url?scp=0024400017&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0024400017&partnerID=8YFLogxK
U2 - 10.1128/AAC.33.7.1101
DO - 10.1128/AAC.33.7.1101
M3 - Article
C2 - 2675757
AN - SCOPUS:0024400017
SN - 0066-4804
VL - 33
SP - 1101
EP - 1104
JO - Antimicrobial agents and chemotherapy
JF - Antimicrobial agents and chemotherapy
IS - 7
ER -