Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0740441 (acute diarrhea)
 2,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One-hundred seventy-four infants and children with acute diarrhea were treated as ambulatory patients with either ampicillin (100 mg/kg/day orally in four divided doses) or trimethoprim sulfamethoxazole (10 mg TMP and 50 mg SMX/KG/day orally in two divided doses). There were 65 patients with shigellosis. Responses of those treated with TMP/SMX and of those with susceptible Shigella treated with ampicillin were comparable. Patients with resistant organisms failed to respond to ampicillin. All Shigella, including ampicillin-resistant strains, were suseptible in vitro to TMP/SMX, and patients with ampicillin-resistant strains responded favorably to treatment with TMP/SMX. TMP/SMX appears to be the best, currently available drug for the treatment of shigellosis.
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PMID:Comparison of trimethoprim-sulfamethoxazole and ampicillin theraphy for shigellosis in ambulatory. 104 83

To explore the optimal dosing regimen for trimethoprim-sulfamethoxazole (TMP-SMX) when used in combination with loperamide to treat traveler's diarrhea, 190 U.S. adults with acute diarrhea were enrolled in a double-blind, randomized trial in Guadalajara, Mexico. All patients received loperamide (4-mg loading dose; 2 mg after each loose stool, not to exceed 16 mg/day for 3 days) and were randomized to receive a 3-day course of TMP-SMX (160:800 mg twice daily for six doses) (group A), a single large dose of TMP-SMX (320:1,600 mg) (group B), or a large loading dose (320:1,600 mg) followed by standard doses for 3 days (160:800 mg twice daily for five doses) (group C). Patients in group C responded best (P < 0.01), with 75% of subjects recovered from diarrhea in 12 h compared with 34 h (group A) and 33 h (group B). Similar differences in favor of group C were noted in the subset of patients who presented with moderate to severe diarrhea. On average, patients in group C took significantly (P < 0.05) less loperamide (1.2 mg) after the 4-mg loading dose compared with patients in group A (2.4 mg) or group B (2.0 mg). We conclude that the most efficacious treatment of traveler's diarrhea in the interior of Mexico is to take loperamide in usual doses to control symptoms in combination with a single large dose of TMP-SMX, which should then be continued for 3 days in standard doses.
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PMID:Optimal dosing of trimethoprim-sulfamethoxazole when used with loperamide to treat traveler's diarrhea. 148 52

Shigella species have been one of the most common causes of acute diarrhea in Bangkok, Thailand. The incidence of shigellosis increased steadily from 1984 to 1988. The majority of Shigella species isolated from specimens from patients with acute diarrhea in Bangkok in 1988 were resistant to both ampicillin and trimethoprim-sulfamethoxazole (TMP-SMZ). Shigella flexneri was the most commonly isolated organism and had the highest rate of resistance to ampicillin, chloramphenicol, TMP-SMZ, and tetracycline. The antimicrobial agents of choice for the treatment of shigellosis have been changed from ampicillin to TMP-SMZ and recently to the fluoroquinolones. We conducted a controlled study of norfloxacin that revealed its efficacy for eradication of Shigella species from the stool of both adults and children. The fluoroquinolones shorten the course of diarrhea, reduce the shedding of the organism, and prevent the spread of infection. No short-term adverse effects of the quinolones were observed in this study; however, its use among children should be restricted to treatment of severe shigellosis and the duration of treatment should be as short as possible.
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PMID:Response to antimicrobial therapy for shigellosis in Thailand. 204 60

The efficacy of trimethoprim-sulfamethoxazole (TMP-SMX) and placebo were compared in a randomized double-blind study of 141 Mexican children with acute diarrhea. Patients who met specific entry criteria received TMP-SMX or an identical appearing placebo for 5 days. Stools were examined for bacterial, viral, and parasitic pathogens. Enterotoxigenic Escherichia coli were the most commonly isolated pathogens (22% of total). Patients given TMP-SMX had a significantly shorter time to "last illness stool" than did those given placebo, but no difference in number of unformed stools in 5 days was found between treatment groups. However, TMP-SMX significantly shortened the illness in patients with fever or many fecal leukocytes. When stool cultures positive for any bacterial pathogen or for enterotoxigenic E. coli were analyzed as separate groups, a significantly faster recovery was observed in patients given TMP-SMX. TMP-SMX is efficacious in the treatment of Mexican children with diarrhea and culture-proved bacterial infection or when the clinical signs and symptoms suggest bacterial enteritis.
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PMID:Efficacy of trimethoprim-sulfamethoxazole in treatment of acute diarrhea in a Mexican pediatric population. 329 63

The efficacy of BW942C, a novel enkephalinlike pentapeptide antidiarrheal agent, was compared with the efficacy of trimethoprim-sulfamethoxazole (TMP-SMX) and the combination of the two agents in a placebo-controlled trial of the 72-h treatment of acute diarrhea. Subjects with diarrhea but without bloody stools or fever greater than 102 degrees F (38.9 degrees C) were enrolled. Administered to 134 U.S. adults with diarrhea that developed shortly after their arrival in Guadalajara, Mexico, BW942C was more efficacious than TMP-SMX in relieving diarrhea and cramps in the first 12 h of therapy, especially among subjects with diarrhea caused by enterotoxigenic E. coli. In the BW942C treatment group, 25% of subjects eventually took additional therapy because their diarrhea did not respond to BW942C alone. Neurological side effects such as dizziness and light-headedness occurred more frequently among BW942C-treated subjects. Therapy for 3 days with TMP-SMX provided lasting relief comparable with previously reported 5-day therapy. Use of the combination of both agents provided the benefits of prompt relief afforded by BW942C and lasting relief afforded by TMP-SMX. BW942C might prove to be an agent suitable for the treatment of acute diarrhea, with TMP-SMX reserved for treatment of those who do not respond adequately. The empiric use of the combination of BW942C and TMP-SMX appears appropriate for the treatment of severe nondysenteric disease.
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PMID:Role of a novel antidiarrheal agent, BW942C, alone or in combination with trimethoprim-sulfamethoxazole in the treatment of traveler's diarrhea. 352 36

Empiric treatment with ciprofloxacin and norfloxacin has been recommended recently for patients with acute diarrhoeal disease. In a retrospective 6-month study period the results of stool cultures from 209 patients with acute diarrhoea admitted to the emergency room were analysed. Seventy-eight cultures (37%) were positive for one or more bacteria. Shigella was the most commonly isolated pathogen (68%). Shigella sonnei comprised 72% and Shigella flexneri 19% of all the bacterial isolates. While no antimicrobial resistance to ciprofloxacin was found for both Shigella species, only 36 and 26% of the Shigella isolates were sensitive to ampicillin and trimethoprim-sulfamethoxazole (TMP-SMZ), respectively. These findings point out to the emergence of drug resistance to commonly used antimicrobial drugs. Shigella's high sensitivity to the newer quinolones should make this the treatment of choice for the very sick patient, although physicians should be cautioned to the fact that indiscriminate use of this drug could result in the emergence of resistance similar to that noted with ampicillin and TMP-SMZ.
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PMID:Acute bacterial diarrhoea in the emergency room: therapeutic implications of stool culture results. 780 82

This study compared the efficacy and safety of lomefloxacin with that of trimethoprim/sulfamethoxazole (TMP/SMX) in the treatment of adult patients with acute diarrhea of bacterial etiology. Two centers enrolled a total of 133 patients; 99 (74%) presented with severe symptoms. The patients were randomized to receive either lomefloxacin 400 mg once daily (n=68) or TMP/SMX 160/800 mg twice daily (n=65) for five days. Bacteriologic success was achieved in 89.5% of evaluation lomefloxacin-treated patients and in 97.5% of patients treated with TMP/SMX. Clinical success was achieved in 100% and 97.5% of patients in the two treatment groups, respectively. The predominant organisms isolated in both groups at baseline, i.e. Shigella flexneri, Vibrio parahaemolyticus, and Salmonella Group D, were eradicated in all patients. Campylobacter jejuni was isolated at baseline in four patients in the lomefloxacin group but in none randomized to receive TMP/SMX; this organism persisted in three patients. Adverse events were experienced by 14 (23%) of the lomefloxacin-treated patients and by 18 (30%) of the TMP/SMX-treated patients. All adverse events reported were mild or moderate in severity and their distribution was similar in both groups. The results of this study show that lomefloxacin 400 mg once daily is as effective as TMP/SMX 160/800 mg twice daily and suggest that lomefloxacin is a promising new quinolone for the treatment of bacterial diarrhea.
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PMID:Lomefloxacin versus trimethoprim/sulfamethoxazole in the treatment of adults with acute bacterial diarrhea. 1861 21