TRIMETHOPRIM-SULFAMETHOXAZOLE THERAPY FOR SHIGELLOSIS

Infants and children (28) hospitalized for severe shigellosis were treated orally with ampicillin trihydrate (100 mg/kg per day administered in divided doses every 6 h) or with trimethoprim-sulfamethoxazole (trimethoprim, 10 mg; sulfamethoxazole, 50 mg/kg per day in divided doses every 12 h) for 5 days. Patients (4) with ampicillin-resistant shigellae continued to have diarrhea and positive stool cultures during therapy. Patients with susceptible shigellae treated with ampicillin and all patients treated with trimethoprim-sulfamethoxazole responded promptly and comparably within an average of 1.6 and 1.7 days, respectively, until stool cultures were negative, and 3.1 and 2.9 days, respectively, until diarrhea stopped. Patients with ampicillin-resistant shigellae responded to treatment with trimethoprim-sulfamethoxazole. Trimethoprim-sulfamethoxazole is apparently the best currently available drug for treatment of shigellosis in areas where multiple antibiotic resistance of shigellae is common.