Treatment of gastrointestinal infections

Studies aimed at improving treatment strategies for patients with acute dia rrhea have included the clinical testing of modifications to the standard o ral rehydration solution. A matabsorbed carbohydrate has been found to impr ove resuscitation, probably through the recruitment of colonic absorptive c apacity. A reduced osmolarity solution is safe in adults and as effective a s the standard solution. For nonnursing infants, increasing the frequency o f feeding with reduced volume results in comparable total caloric intake an d diminishes the risk of prolonged diarrhea. Increasing resistance of impor tant enteric pathogens to inexpensive and newer antibiotics continues to be a concern. Reports from Asia of decreased Salmonella typhi resistance to c hloramphenicol, attributed to restricted antibiotic usage, may indicate a r eversal of the usual trend. A strategy to block the action of shiga toxins in the gut through the use of recombinant bacteria has shown promise in a m ouse model. A small but well-designed study supported the use of either nor floxacin or amoxicillin-clavulanic acid in the treatment of small bower ove rgrowth syndrome. Studies exploring passive immunity strategies for the tre atment of Escherichia coli, Cryptosporidium, and Candida infections have re ported variable levels of success. (C) 2001 Lippincott Williams & Wilkins, Inc.