COMPARATIVE EFFICACY OF CEFIXIME AND AMPICILLIN-SULBACTAM IN SHIGELLOSIS IN CHILDREN

Shigellosis is still an important health problem in developing and und erdeveloped countries as it is resistance to commonly used antibiotics including ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol and tetracycline. Between May 1996 and October 1996, in a prospective randomized double-blind trial, cefixime was compared with ampicillin-s ulbactam, both given orally for a period of 5 days, for the treatment of SO children with acute bloody diarrhea. Forty patients were treated with a single-dose (8 mg/kg per day) of cefixime and the other 40 pat ients were given three doses of 100 mg/kg per day of ampicillin-sulbac tam. After identification of Shigella organisms in stool specimens, ni ne patients in the cefixime receiving group and six patients in the am picillin-sulbactam receiving group were excluded from the study. Diffe rences in average age, sex and weight between the cefixime and ampicil lin-sulbactam group were statistically meaningless (P > 0.05). Fever a nd bloody diarrhea were universal features. The efficacy of cefixime w as found to be better than ampicillin-sulbactam. Patients given cefixi me had a shorter duration of fever (P<0.01), shorter duration to disap pearance of blood in the stool (P<0.01), reduced time with diarrhea (P <0.01) and reduced hospitalization time during the 5 study days (P<0.0 1) than patients given ampicillin-sulbactam. No adverse effects were o bserved in the two study groups. This controlled trial showed good eff icacy with cefixime compared to ampicillin-sulbactam in the treatment of shigellosis. Single-dose daily oral therapy with cefixime also show ed good tolerability. Cefixime should be considered as an alternative drug of choice for shigellosis in children.