In a double-blind study of the treatment of disease caused by enterotoxigenic Escherichia coli (ETEC), diarrhea was induced in volunteers with a trimethoprim (TMP)- and sulfamethoxazole (SMZ)-susceptible strain of E. coli that produces both heat-stable and heat-labile toxin. III volunteers were then treated with TMP, TMPSMZ, or placebo. Volunteers treated with both TMP alone and the TMP-SMZ combination showed a substantial decrease in the duration and severity of the illness, as compared with the placebo-treated controls. TMP-resistant (MIC, 3.1-12.5 IAg/ml) ETEC were isolated from stool cultures of five of 10 TMP-treated volunteers and none of 10 TMP-SMZ-treated volunteers after 48 hr of therapy, and in two volunteers the appearance of resistant organisms was associated with a clinical relapse. These data suggest that the TMP-SMZ combination should be evaluated in field trials to determine its usefulness as an adjunct to replacement of fluid and electrolytes in the therapy of ETEC diarrhea.
ASJC Scopus subject areas
- Microbiology (medical)