Antibiotics for the treatment of dysentery in children
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.
Full-textDOI: · Available from: Melinda K Munos, Jan 15, 2014
- SourceAvailable from: Zohra S Lassi
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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) . 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%) . 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). "
ABSTRACT: Child health is a growing concern at the global level, as infectious diseases and preventable conditions claim hundreds of lives of children under the age of five in low-income countries. Approximately 7.6 million children under five years of age died in 2011, calculating to about 19 000 children each day and almost 800 every hour. About 80 percent of the world's under-five deaths in 2011 occurred in only 25 countries, and about half in only five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan and China. The implications and burden of such statistics are huge and will have dire consequences if they are not corrected promptly. This paper reviews essential interventions for improving child health, which if implemented properly and according to guidelines have been found to improve child health outcomes, as well as reduce morbidity and mortality rates. It also includes caregivers and delivery strategies for each intervention. Interventions that have been associated with a decrease in mortality and disease rates include exclusive breastfeeding, complementary feeding strategies, routine immunizations and vaccinations for children, preventative zinc supplementation in children, and vitamin A supplementation in vitamin A deficient populations.Reproductive Health 08/2014; 11(Suppl 1):S4. DOI:10.1186/1742-4755-11-S1-S4 · 1.62 Impact Factor
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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  has evaluated the effectiveness of antibiotics for Shigella in children and adults, while the review by Traa et al  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. "
ABSTRACT: Diarrhea is a major contributor to the burden of morbidity and mortality in children; it accounts for a median of 11% of all deaths among children aged less than 5 years, amounting to approximately 0.8 million deaths per year. Currently there is a dearth of literature exploring the effectiveness of antibiotics for diarrhea due to Cholera, Shigella and cryptosporidiosis in children. We reviewed the literature reporting the effect of antibiotics for the treatment of diarrhea due to Cholera, Shigella and Cryptosporidium in children under five years. We used a standardized abstraction and grading format and performed meta-analyses to determine the effect of the treatment with various antibiotics on mortality and rates of clinical and bacteriological/parasitological failure. The CHERG Standard Rules were applied to determine the final effect of treatment with antibiotics on diarrhea morbidity and mortality. For Cholera; the evidence was weak to recommend any effect on mortality. For Shigella; there was no data on mortality; either all-cause or cause specific, hence we used clinical failure rates as a proxy for Shigella deaths and propose that treatment of Shigella dysentery with antibiotics can result in a 82% reduction in diarrhea mortality due to Shigella. For cryptosporidiosis; there was data on all-cause mortality but the evidence was weak hence we used clinical failure rates as a proxy for mortality to estimate that antimicrobial treatment of diarrhea due to cryptosporidiosis can result in a 54% reduction in mortality. There is evidence to recommend antibiotic use for reduction of morbidity and mortality due to Cholera, Shigella and Cryptosporidium. We recommend that more clinical trials should be conducted to evaluate the efficacy and safety of first- and second- line drugs currently in use for treatment for diarrhea and dysentery in both developing and developed countries.BMC Public Health 09/2013; 13 Suppl 3(Suppl 3):S10. DOI:10.1186/1471-2458-13-S3-S10 · 2.32 Impact Factor
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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. "
ABSTRACT: Preventable and treatable childhood diseases, notably acute respiratory infections and diarrhoeal diseases are the first and second leading causes of death and morbidity among young children in developing countries. The fact that a large proportion of child deaths are caused by these diseases is symptomatic of dysfunctional policy strategies and health systems in the developing world. Though clinical interventions against such diseases have been thoroughly studied, non-clinical interventions have received much less attention. This paper contributes to the existing literature on child wellbeing in two important respects: first, it presents a theory of change-based typology that emerges from a systematic review conducted on non-clinical interventions against preventable and treatable childhood diseases. Second, it pays particular attention to policies that have been tested in a developing country context, and which focus on children as the primary target population. Overall, we find that improved water supply and quality, sanitation and hygiene, as well as the provision of medical equipment that detect symptoms of childhood diseases, along with training and education for medical workers, are effective policy instruments to tackle diarrhoeal diseases and acute respiratory infections in developing countries.SSRN Electronic Journal 09/2013; DOI:10.2139/ssrn.2325892