Pivmecillinam, co-trimoxazole and oral mecillinam in gastroenteritis due to <i>Vibrio</i> spp

Uylangco, C.; Santiago, Lourdes; Pescante, Mario; Menday, Paul; Christensen, Ole

doi:10.1093/jac/13.2.171

Cited by 4 publications

(3 citation statements)

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“…Twenty-three studies were excluded for reasons specified in Characteristics of excluded studies. We were unable to obtain one article (Chatchai 1994) and three ongoing studies were identified (see the Characteristics of ongoing studies table).…”

Section: Resultsmentioning

confidence: 99%

Antimicrobial drugs for treating cholera

Leibovici-Weissman

Neuberger

Bitterman

et al. 2014

Cochrane Database of Systematic Reviews

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Background Cholera is an acute watery diarrhoea caused by infection with the bacterium Vibrio cholerae, which if severe can cause rapid dehydration and death. Effective management requires early diagnosis and rehydration using oral rehydration salts or intravenous fluids. In this review, we evaluate the additional benefits of treating cholera with antimicrobial drugs. Objectives To quantify the benefit of antimicrobial treatment for patients with cholera, and determine whether there are differences between classes of antimicrobials or dosing schedules. Search methods We searched the Cochrane Infectious Disease Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; African Index Medicus; LILACS; Science Citation Index; metaRegister of Controlled Trials; WHO International Clinical Trials Registry Platform; conference proceedings; and reference lists to March 2014. Selection criteria Randomized and quasi‐randomized controlled clinical trials in adults and children with cholera that compared: 1) any antimicrobial treatment with placebo or no treatment; 2) different antimicrobials head‐to‐head; or 3) different dosing schedules or different durations of treatment with the same antimicrobial. Data collection and analysis Two reviewers independently applied inclusion and exclusion criteria, and extracted data from included trials. Diarrhoea duration and stool volume were defined as primary outcomes. We calculated mean difference (MD) or ratio of means (ROM) for continuous outcomes, with 95% confidence intervals (CI), and pooled data using a random‐effects meta‐analysis. The quality of evidence was assessed using the GRADE approach. Main results Thirty‐nine trials were included in this review with 4623 participants. Antimicrobials versus placebo or no treatment Overall, antimicrobial therapy shortened the mean duration of diarrhoea by about a day and a half compared to placebo or no treatment (MD ‐36.77 hours, 95% CI ‐43.51 to ‐30.03, 19 trials, 1013 participants, moderate quality evidence ). Antimicrobial therapy also reduced the total stool volume by 50% (ROM 0.5, 95% CI 0.45 to 0.56, 18 trials, 1042 participants, moderate quality evidence ) and reduced the amount of rehydration fluids required by 40% (ROM 0.60, 95% CI 0.53 to 0.68, 11 trials, 1201 participants, moderate quality evidence ). The mean duration of fecal excretion of vibrios was reduced by almost three days (MD 2.74 days, 95% CI ‐3.07 to ‐2.40, 12 trials, 740 participants, moderate quality evidence). There was substantial heterogeneity in the size of these benefits, probably due to differences in the antibiotic used, the trial methods (particularly effective randomization), and the tim...

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Section: Resultsmentioning

confidence: 99%

Antimicrobial drugs for treating cholera

Leibovici-Weissman

Neuberger

Bitterman

et al. 2014

Cochrane Database of Systematic Reviews

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“…Majority of the ElTor strains in this study was resistant to ampicillin and furazolidone and a similar trend is seen in Calcutta. Since cholera is a non-invasive disease, drugs such as co-trimoxazole, which is not absorbed from the gastrointestinal tract, was widely used for the treatment [18,19]. Resistance of an ElTor strain of V. cholerae to trimethoprim, streptomycin and the vibriostatic agent O\129 (2,4-diamino-6,7-diisopropylpteridine) is due to a transposon inserted into the chromosome [20], whose transfer is being enhanced by pretreatment with these drugs for which the markers encode resistance.…”

Section: Discussionmentioning

confidence: 99%

Expanding multiple antibiotic resistance among clinical strains of Vibrio cholerae isolated from 1992–7 in Calcutta, India

et al. 2000

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Antimicrobial susceptibilities of Vibrio cholerae strains isolated from cholera patients admitted to the Infectious Diseases Hospital, Calcutta, India for 6 years were analysed to determine the changing trends; 840 V. cholerae strains isolated in 1992-1997 were included in this study. Among V. cholerae serogoup O1 and O139, ampicillin resistance increased from 1992 (35 and 70%, respectively) to 1997 (both serogroups 100%). Resistance to furazolidone and streptomycin was constantly high among V. cholerae O1 strains with gradual increase in resistance to other drugs such as ciprofloxacin, co-trimoxazole, neomycin and nalidixic acid. V. cholerae O139 strains exhibited susceptibilities to furazolidone and streptomycin comparable with those of O1 strains. However, after initial increase in resistance to chloramphenicol and co-trimoxazole, all the V. cholerae O139 strains became susceptible to these two drugs from 1995 onwards. Both V. cholerae O1 and O139 remained largely susceptible to gentamicin and tetracycline. V. cholerae non-O1, non-O139 strains, in contrast, exhibited high levels of resistance to virtually every class of antimicrobial agents tested in this study especially from 1995. Kruskal-Wallis one-way analysis showed that V. cholerae O1 Ogawa serogroup exhibited significant yearly increase in resistance to nine antibiotics followed by non-O1 non-O139 and O139 strains to six antibiotics and two antibiotics respectively. Interesting observation encountered in this study was the dissipation of some of the resistant patterns commonly found among V. cholerae non-O1 non-O139 or O1 serogroups to the O139 serogroup and vice versa during the succeeding years.

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“…Vibrios are sensitive to many antibiotics in vitro, including doxycycline, fluoroquinolones, combination trimethoprim and sulfamethoxazole, carbapenems, and pivmecillinam [27]. Early intervention is critical, particularly when bullous disease has developed, as the a priori likelihood of V. vulnificus is increased.…”

Section: Bacterial Gastroenteritismentioning

confidence: 99%

Foodborne illnesses

Gill

Hamer

2001

Curr Treat Options Gastro

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Foodborne illnesses cause a substantial human and financial burden. Despite sanitary infrastructure improvements, the incidence of foodborne bacterial infections due to non-typhoidal salmonellae (NTS), Campylobacter jejuni, and enterohemorrhagic Escherichia coli (EHEC) has risen over the last two decades. Overall, viruses account for two thirds of all foodborne illness. Most foodborne illnesses are self-limited. Supportive therapy with rehydration and the correction of electrolyte abnormalities is usually sufficient. Antibiotics play a beneficial role in the treatment of patients with certain foodborne diseases, such as listeriosis and typhoid fever, and all patients with tissue invasive or bloodstream infections. Immunocompromised patients should be treated presumptively. Antibiotics are of variable efficacy for the treatment of many infections limited to the gastrointestinal tract, and recommendations differ between pathogens. Antibiotics are generally helpful for shigellosis and cholera, and possibly beneficial for campylobacteriosis. However, antibiotics are potentially harmful in uncomplicated NTS and EHEC gastroenteritis and generally should not be used. Toxin-mediated food poisoning usually does not require specific therapy. The exception is botulism, for which botulinum antitoxin is highly efficacious if used early in the course of illness. Empiric therapy for gastroenteritis is possibly beneficial, though the magnitude of benefit is modest and incurs the risk of inadvertently treating NTS or EHEC. The choice of antibiotic should be based on local resistance patterns and the results of susceptibility testing.

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Pivmecillinam, co-trimoxazole and oral mecillinam in gastroenteritis due to Vibrio spp

Cited by 4 publications

References 0 publications

Antimicrobial drugs for treating cholera

Antimicrobial drugs for treating cholera

Expanding multiple antibiotic resistance among clinical strains of Vibrio cholerae isolated from 1992–7 in Calcutta, India

Foodborne illnesses

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