SHORT-COURSE NORFLOXACIN AND TRIMETHOPRIM-SULFAMETHOXAZOLE TREATMENT OF SHIGELLOSIS AND SALMONELLOSIS IN EGYPT

In a double-blind clinical study, 109 adult Egyptian patients infected with Shigella spp. and 45 infected with Salmonella spp. were randomly assigned to three treatment groups: 1) norfloxacin in a single 800-mg dose, 2) norfloxacin, 400 mg twice a day for three days, and 3) trime thoprim (160 mg)-sulfamethoxazole (800 mg) (TMP-SMX), twice a day for three days. Among Shigella-infected patients, diarrheal symptoms had r esolved in 86-97% and bacteriologic failure (repeat positive stool cul ture) occurred in only two patients five days after the start of the t hree treatment regimens. Among Salmonella-infected patients, diarrheal symptoms had resolved in 76-82% of patients and bacteriologic failure was common (18-36%) five days after the start of therapy. These data indicate that short-course therapy with either norfloxacin or TMP-SMX can be effectively used to treat shigellosis in adults in developing c ountries. However, for uncomplicated Salmonella spp. infection, short- course therapy with norfloxacin and TMP-SMX may not lead to a rapid re solution of symptoms or consistently eliminate this enteropathogen.