N. Kaminski et al., ACUTE BACTERIAL DIARRHEA IN THE EMERGENCY ROOM - THERAPEUTIC IMPLICATIONS OF STOOL CULTURE RESULTS, Journal of accident & emergency medicine, 11(3), 1994, pp. 168-171
Citations number
NO
Categorie Soggetti
Emergency Medicine & Critical Care","Medicine, General & Internal
Empiric treatment with ciprofloxacin and norfloxacin has been recommen
ded recently for patients with acute diarrhoeal disease. In a retrospe
ctive 6-month study period the results of stool cultures from 209 pati
ents 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 sonn
ei comprised 72% and Shigella flexneri 19% of all the bacterial isolat
es. While no antimicrobial resistance to ciprofloxacin was found for b
oth Shigella species, only 36 and 26% of the Shigella isolates were se
nsitive to ampicillin and trimethoprim-sulfamethoxazole (TMP-SMZ), res
pectively. These findings point out to the emergence of drug resistanc
e 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 fac
t that indiscriminate use of this drug could result in the emergence o
f resistance similar to that noted with ampicillin and TMP-SMZ.