COMPARISON OF PIVMECILLINAM AND NALIDIXIC-ACID IN THE TREATMENT OF ACUTE SHIGELLOSIS IN CHILDREN

The efficacy of oral pivmecillinam was compared with nalidixic acid in the treatment of acute shigellosis in children 1-8 years of age. In a double-blind trial we studied 80 comparable children with bloody diar rhoea of less than 3 days' duration. Shigella spp. was isolated in 71 children. Patients were randomly assigned to receive either pivmecilli nam, 50 mg/kg.day, or nalidixic acid, 60 mg/kg.day, both given orally for 5 days. The stool frequency decreased progressively in both treatm ent groups. Nalidixic acid failed to eradicate Shigella species in 10 patients, compared with three in the pivmecillinam group (p = 0.04). S imilarly, clinical failure was observed in 11 of 37 patients receiving nalidixic acid and in 2 of 26 patients infected with nalidixic acid-s usceptible strains as against none in the group receiving pivmecillina m. The results suggest that pivmecillinam given orally was, in fact, m ore effective than nalidixic acid in the treatment of acute shigellosi s in children, particularly when the resistant strains are taken into account.