Treatment of gastrointestinal infections

During the past year, we have seen the continuing spread of antimicrobial d rug resistance in important gastrointestinal pathogens. Typhoid fever seen in the United States was multidrug resistant, but still susceptible to quin olones, The mechanism of quinolone resistant typhoid in Vietnam was better elucidated. Treatment failures in enterobacteriaceae treated with quinolone s suggest that the minimum inhibitory concentration break point for resista nce should be lowered. Evidence is mounting that ciprofloxacin and ofloxaci n may be safely used to treat serious infections in children. Cefixime show ed some promise in treating shigellosis in an open labeled trial. Decreased gastric acid secretion was associated with cholera but not dysentery. Phas e 1 trials of vaccines for cholera and enterotoxigenic Escherichia coli sho wed promise, The antifungal drug, clotrimazole, demonstrated ability to inh ibit secretory diarrhea in laboratory studies. Nitazoxanide demonstrated ef ficacy in both protozoan and helminthic infections in humans, including fas cioliasis.