Comparative efficacy of pivmecillinam and cotrimoxazole in acute shigellosis in children.

Abstract

In a prospective randomized double-blind trial, pivmecillinam was compared with cotrimoxazole (TMP-SMX), both given orally for a period of 5 days, for the treatment of 59 children with shigellosis. 29 patients were treated with pivmecillinam and 30 with cotrimoxazole. 14% of shigella organisms isolated were resistant to pivmecillinam and 21% to TMP-SMX. The diarrhea persisted for a mean (+/- SD) period of 74 +/- 24.8 h in the pivmecillinam-treated patients versus 73.8 +/- 34 h in the TMP-SMX-treated patients. Duration of fever, positive stool culture, visible blood, occult blood, and pus cells in the stools were similar for both treatment groups. Five patients (17%) in the pivmecillinam group and 4 patients (13%) in the cotrimoxazole group fulfilled the clinical criteria that defined treatment failure. One patient (3.4%) in the pivmecillinam group and 2 (6.6%) in the TMP-SMX group evidenced recurrence of the diarrheal symptoms at the follow-up visit. No major drug-related side effects were observed in either group. We concluded that pivmecillinam is equivalent to cotrimoxazole in the treatment of shigellosis in children.

• Authors: D Prado, H Liu, T Velasquez, T G Cleary
• Journal: Scandinavian journal of infectious diseases (Scand J Infect Dis) Vol. 25 Issue 6 Pg. 713-9 ( 1993) ISSN: 0036-5548 [Print] England
• PMID: 8052810 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Amdinocillin Pivoxil
• Trimethoprim, Sulfamethoxazole Drug Combination

Topics

• Acute Disease
• Adolescent
• Amdinocillin Pivoxil (pharmacology, therapeutic use)
• Child
• Child, Preschool
• Double-Blind Method
• Dysentery, Bacillary (drug therapy, microbiology)
• Female
• Humans
• Infant
• Male
• Prospective Studies
• Shigella (drug effects, isolation & purification)
• Trimethoprim, Sulfamethoxazole Drug Combination (therapeutic use)