Article

Antibiotics for the treatment of dysentery in children

Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
International Journal of Epidemiology (Impact Factor: 9.2). 04/2010; 39 Suppl 1(Suppl 1):i70-4. DOI: 10.1093/ije/dyq024
Source: PubMed

ABSTRACT Ciprofloxacin, ceftriaxone and pivmecillinam are the antibiotics currently recommended by the World Health Organization (WHO) for the treatment of dysentery in children; yet there have been no reviews of the clinical effectiveness of these antibiotics in recent years.
We reviewed all literature reporting the effect of ciprofloxacin, ceftriaxone and pivmecillinam for the treatment of dysentery in children in the developing countries. We used a standardized abstraction and grading format and performed meta-analyses to determine the effect of treatment with these antibiotics on rates of treatment failure, bacteriological failure and bacteriological relapse. The CHERG Standard Rules were applied to determine the final effect of treatment with these antibiotics on diarrhoea mortality.
Eight papers were selected for abstraction. Treatment with ciprofloxacin, ceftriaxone or pivmecillinam resulted in a cure rate of >99% while assessing clinical failure, bacteriological failure and bacteriological relapse.
The antibiotics recommended by the WHO--ciprofloxacin, ceftriaxone and pivmecillinam--are effective in reducing the clinical and bacteriological signs and symptoms of dysentery and thus can be expected to decrease diarrhoea mortality attributable to dysentery.

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Available from: Melinda K Munos, Jan 15, 2014
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    • "Reduced episodes of diarrhoea at follow-up were seen with Furazolidone versus no drug (RR 0.21; 95% CI: 0.09, 0.48) as well as with cotrimoxazole versus no drug (RR 0.30; 95% CI: 0.15, 0.59) [72]. However, treatment with one of the three WHO-recommended antibiotics (ciprofloxacin, ceftriaxone and pivmecillinam) resulted in a clinical failure rate of 0.1% (95% CI: −0.2, 0.5%) [73]. On the other hand, when two different antibiotics (Pivmecillinam and Ciprofloxacin) were used it resulted in 82% reduction in clinical failure (RR 0.18; 95% CI: 0.10, 0.33). "
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    • "We reviewed the scientific evidence available for the use of antibiotics in the treatment of diarrhea due to Cholera, Shigella and Cryptosporidium in children, as well as differences in the effectiveness of various antibiotics. A Cochrane review [20] has evaluated the effectiveness of antibiotics for Shigella in children and adults, while the review by Traa et al [21] had evaluated the effectiveness of antibiotics for dysentery and estimated a cure rate of > 99%. We in this review have taken studies with confirmed cases of Shigella only, so have estimated the effect of antibiotics on Shigella cases. "
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    • "Clinical interventions for diarrhoea and respiratory infections such as antibiotics, probiotics, and zinc have been implemented and assessed under various environmental settings (Theodoratou et al. 2010; Traa et al. 2010; Dennehy 2012; Soares-Weiser et al. 2010; Dinleyici et al. 2012; Das et al. 2010; Das et al. 2012; Lazzerini and Ronfani 2011). In contrast, the effectiveness of non-clinical interventions characterized by education and training programmes, and/or improved sanitation, water supply, water quality, and hospital equipment is comparatively under-studied. "
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