salicylates and Escherichia-coli-Infections

Travelers' diarrhea is the most common travel-related malady. It affects millions of international travelers to developing countries annually and can significantly disrupt travel plans.. To provide an update on the evaluation, diagnosis, treatment, and prevention of traveler's diarrhea.. A PubMed search was completed in Clinical Queries using the key term "traveler's diarrhea". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature. Patents were searched using the key term "traveler's diarrhea" from www.freepatentsonline.com.. Between 10% and 40% of travelers develop diarrhea. The attack rate is highest for travelers from a developed country who visit a developing country. Children are at particular risk. Travelers' diarrhea is usually acquired through ingestion of food and water contaminated by feces. Most cases are due to a bacterial pathogen, commonly, Escherichia coli, and occur within the first few days after arrival in a foreign country. Dehydration is the most common complication. Pretravel education on hygiene and on the safe selection of food items is important in minimizing episodes. For mild travelers' diarrhea, the use of antibiotic is not recommended. The use of bismuth subsalicylate or loperamide may be considered. For moderate travelers' diarrhea, antibiotics such as fluoroquinolones, azithromycin, and rifaximin may be used. Loperamide may be considered as monotherapy or adjunctive therapy. For severe travelers' diarrhea, antibiotics such as azithromycin, fluoroquinolones, and rifaximin should be used. Azithromycin can be used even for the treatment of dysentery whereas fluoroquinolones and rifaximin cannot be used for such purpose. Recent patents related to the management of travelers' diarrhea are discussed.. Although travelers' diarrhea is usually self-limited, many travelers prefer expedient relief of diarrhea, especially when they are traveling for extended periods by air or ground. Judicious use of an antimotility agent and antimicrobial therapy reduces the duration and severity of diarrhea.

Topics: Anti-Bacterial Agents; Azithromycin; Bismuth; Dehydration; Developing Countries; Dysentery; Escherichia coli; Escherichia coli Infections; Fluoroquinolones; Food Contamination; Health Knowledge, Attitudes, Practice; Humans; Loperamide; Organometallic Compounds; Patient Education as Topic; Salicylates

Various available forms of therapy can decrease morbidity and mortality associated with acute diarrhea. Oral fluids represent the cornerstone of therapy of all cases. A variety of agents acting nonspecifically can decrease diarrhea and improve other worrisome symptoms associated with enteric infection. Kaopectate makes the stool more formed but has little additional effects. Bismuth subsalicylate, an antisecretory agent, reduces the number of stools passed by about 50 percent and improves other associated symptomatology. The drugs that affect motility such as loperamide and diphenoxylate are the most active of the nonspecifically acting drugs. They must be avoided in patients with significant fever and dysentery. Trimethoprim/sulfamethoxazole is now considered the drug of choice for shigellosis due to the presence of ampicillin-resistant Shigella strains in most regions of the world. Trimethoprim/sulfamethoxazole is also an effective form of therapy for enterotoxigenic Escherichia coli infection and for traveler's diarrhea without definable cause. Erythromycin, although not proved to be effective against Campylobacter, probably shortens the disease. Furazolidone, although not dramatically effective, has a spectrum of activity that includes Shigella, enterotoxigenic E. coli, Campylobacter, and Giardia lamblia. It may not be effective in severely ill (hospitalized) patients with diarrhea. The various forms of available therapy can be administered empirically, depending on symptomatology. Mildly ill patients (one to three unformed stools in 24 hours with minimal additional symptoms) probably are best treated with fluids only. Mild to moderately ill persons (three to six unformed stools in 24 hours) can be treated with a drug that acts nonspecifically, such as bismuth subsalicylate or loperamide. Those with severe diseases (six or more unformed stools with moderate to severe associated symptoms), particularly when associated with fever and the passage of bloody mucoid stools, may be given an antimicrobial agent. The antimicrobial drug given will be determined by ancillary laboratory tests (dark-field examination or examination of a wet-mount preparation for motile Campylobacter or stool culture for Shigella, Campylobacter, or Salmonella) or may be administered on an empiric basis. Traveler's diarrhea can be eliminated in selected persons by the administration of a pharmacologic agent. Liquid bismuth subsalicylate is effective in large doses, which may be impr

Topics: Acute Disease; Adult; Anti-Infective Agents; Bismuth; Campylobacter Infections; Child; Child, Preschool; Clinical Trials as Topic; Diarrhea; Diarrhea, Infantile; Drug Combinations; Dysentery, Amebic; Dysentery, Bacillary; Escherichia coli Infections; Giardiasis; Humans; Infant; Kaolin; Loperamide; Narcotics; Organometallic Compounds; Parasympatholytics; Pectins; Salicylates; Salmonella Infections; Travel

Three hundred million people, mostly tourists, participate in international travel each year. Development of an acute diarrheal syndrome abroad, while returning home, or shortly after arriving home is referred to as traveler's diarrhea (TD). TD is not a specific diagnosis but, rather, a clinical syndrome with multiple etiologies. In this article, clinical and epidemiological features of TD, specific etiologies and their pathogenesis, as well as current means of diagnosis, treatment, and prevention will be reviewed.

Topics: Anti-Bacterial Agents; Antidiarrheals; Bismuth; Campylobacter Infections; Diarrhea; Diet; Dysentery, Bacillary; Escherichia coli Infections; Fluid Therapy; Giardiasis; Humans; Intestines; Organometallic Compounds; Risk; Salicylates; Salmonella Infections; Time Factors; Travel; Vaccination; Vibrio Infections; Vibrio parahaemolyticus

A 42-d floor pen study was conducted with broiler chickens comparing the effects on bird performance of 12 ppm TAMUS 2032 (also known as BT) and 55 ppm bacitracin methylene disalicyclate (BMD) when fed alone or in combination with 99 ppm monensin (MON). Unmedicated and 99 ppm MON treatments were included in the study design. Beginning on d 22 of study, birds in all 6 treatments were subjected to a modulated house temperature and airflow to mimic conditions conducive to outbreaks of colibacillosis. A natural outbreak of colibacillosis developed beginning on d 27. Primary lesions in dead birds included airsacculitis and pericarditis with occasional findings of perihepatitis. At d 42 of study, means for weight gain in the TAMUS 2032 and TAMUS 2032 + MON treatments were greater in comparison with the unmedicated and BMD treatments, and means for feed conversion for both treatments were improved in comparison with the unmedicated treatment. Mean feed conversion in the TAMUS 2032 + MON treatment was also improved in comparison with BMD treatment. Mortality due to colibacillosis was reduced in the TAMUS 2032 (0.051%), TAMUS 2032 + MON (0.642%), and MON + BMD (1.515%) treatments in comparison with the unmedicated treatment (13.402%) and the BMD treatment (11.159%). The results of improved performance and reduced mortality indicated that 12 ppm TAMUS 2032 was highly efficacious against colibacillosis in growing chickens. The reduced mortality percentages in the MON + BMD treatment indicated that this combination also provided a good level of protection against the natural outbreak of colibacillosis.

Topics: Animals; Bacitracin; Chickens; Disease Outbreaks; Drug Therapy, Combination; Escherichia coli Infections; Female; Hepatitis, Animal; Hot Temperature; Housing, Animal; Male; Monensin; Oligopeptides; Pericarditis; Poultry Diseases; Salicylates; Ventilation

A controlled, randomized, double-blind study in Bangladeshi children (ages 4-36 mo) with acute diarrhoea was undertaken to determine whether bismuth subsalicylate (BSS) would prevent the development of persistent diarrhoea (PD) in young children. The children were randomized to two groups: 226 were given liquid oral BSS, (as Pepto-Bismol), 100 mg/kg/d for 5 d; 225 were given placebo of identical appearance. On admission to the study, the two groups were comparable both clinically and microbiologically. Rotavirus was found in 56% of all the children, and enterotoxigenic E. coli in 31% of a subsample studied. Children treated with BSS had less severe and less prolonged illness than those treated with placebo (p = 0.057). There was, however, no difference in the development of PD between the two groups (8% and 11%). Unexpectedly, patients treated with BSS gained significantly more weight (2.3%) than those treated with placebo (0.5%; p < 0.001) during the course of the study. No toxicity of BSS was detected.. Treatment with BSS had a modest therapeutic effect on acute diarrhoea, as has been previously demonstrated, but with no suggestion of a therapeutic effect on the prevention of persistent diarrhoea in this group of patients.

Topics: Acute Disease; Bismuth; Child, Preschool; Diarrhea; Double-Blind Method; Escherichia coli Infections; Humans; Infant; Organometallic Compounds; Rehydration Solutions; Retroviridae Infections; Salicylates

Bismuth subsalicylate (BSS) and placebo were evaluated in a double-blind, placebo-controlled study as adjunct to rehydration therapy in 123 children, aged 4 to 28 months, hospitalized with acute diarrhea. The dosing regimen was 20 mg/kg five times daily for 5 days. Significant benefits were noted in the BSS group compared with placebo as manifested by decreases in stool frequency and stool weights and an improvement in stool consistency, significant improvement in clinical well-being, and shortening of the disease duration. Patients treated with BSS had a significant reduction in duration of hospital stay (6.9 days) compared with placebo-treated patients (8.5 days). Also, intravenous fluid requirements decreased significantly more rapidly and to a greater degree in the BSS-treated group. Bismuth subsalicylate was associated with clearance of pathogenic Escherichia coli from the stools in 100% of cases but was not different from placebo in rotavirus elimination. Bismuth subsalicylate was well tolerated with no reported adverse effects. Blood bismuth and serum salicylate levels were well below levels considered toxic. In this study, BSS provided effective adjunctive therapy for acute diarrhea, allowing children to get well sooner with less demand on the nursing and hospital staff.

Topics: Acute Disease; Bismuth; Child, Preschool; Diarrhea, Infantile; Double-Blind Method; Escherichia coli Infections; Feces; Fluid Therapy; Humans; Infant; Length of Stay; Organometallic Compounds; Rotavirus Infections; Salicylates

Various available forms of therapy can decrease morbidity and mortality associated with acute diarrhea. Oral fluids represent the cornerstone of therapy of all cases. A variety of agents acting nonspecifically can decrease diarrhea and improve other worrisome symptoms associated with enteric infection. Kaopectate makes the stool more formed but has little additional effects. Bismuth subsalicylate, an antisecretory agent, reduces the number of stools passed by about 50 percent and improves other associated symptomatology. The drugs that affect motility such as loperamide and diphenoxylate are the most active of the nonspecifically acting drugs. They must be avoided in patients with significant fever and dysentery. Trimethoprim/sulfamethoxazole is now considered the drug of choice for shigellosis due to the presence of ampicillin-resistant Shigella strains in most regions of the world. Trimethoprim/sulfamethoxazole is also an effective form of therapy for enterotoxigenic Escherichia coli infection and for traveler's diarrhea without definable cause. Erythromycin, although not proved to be effective against Campylobacter, probably shortens the disease. Furazolidone, although not dramatically effective, has a spectrum of activity that includes Shigella, enterotoxigenic E. coli, Campylobacter, and Giardia lamblia. It may not be effective in severely ill (hospitalized) patients with diarrhea. The various forms of available therapy can be administered empirically, depending on symptomatology. Mildly ill patients (one to three unformed stools in 24 hours with minimal additional symptoms) probably are best treated with fluids only. Mild to moderately ill persons (three to six unformed stools in 24 hours) can be treated with a drug that acts nonspecifically, such as bismuth subsalicylate or loperamide. Those with severe diseases (six or more unformed stools with moderate to severe associated symptoms), particularly when associated with fever and the passage of bloody mucoid stools, may be given an antimicrobial agent. The antimicrobial drug given will be determined by ancillary laboratory tests (dark-field examination or examination of a wet-mount preparation for motile Campylobacter or stool culture for Shigella, Campylobacter, or Salmonella) or may be administered on an empiric basis. Traveler's diarrhea can be eliminated in selected persons by the administration of a pharmacologic agent. Liquid bismuth subsalicylate is effective in large doses, which may be impr

Topics: Acute Disease; Adult; Anti-Infective Agents; Bismuth; Campylobacter Infections; Child; Child, Preschool; Clinical Trials as Topic; Diarrhea; Diarrhea, Infantile; Drug Combinations; Dysentery, Amebic; Dysentery, Bacillary; Escherichia coli Infections; Giardiasis; Humans; Infant; Kaolin; Loperamide; Narcotics; Organometallic Compounds; Parasympatholytics; Pectins; Salicylates; Salmonella Infections; Travel

Topics: Bismuth; Clinical Trials as Topic; Diarrhea; Double-Blind Method; Enterotoxins; Escherichia coli; Escherichia coli Infections; Humans; Organometallic Compounds; Salicylates; Travel

Enterotoxigenic Escherichia coli cause most traveler's diarrhea in Third World countries. We tested bismuth subsalicylate as prophylactic therapy and as treatment for enterotoxigenic E. coli-induced diarrhea. Thirty-two healthy hospitalized volunteers were challenged orally with enterotoxigenic E. coli, strain H10407 (serotype 078:K80:H11). Administration of 600-mg doses of bismuth subsalicylate or placebo was begun 8 h before bacterial challenge. Doses were taken at 8 h and 2 h before, and at 2 h and 4 h after, the E. coli challenge and were continued four times a day for 3 additional days. The maximum prophylactic bismuth subsalicylate dose was 9.6 g. Those experiencing diarrhea were rerandomized to receive bismuth subsalicylate or placebo, given as 300 mg every 30 min for a total of 2.4 g of bismuth subsalicylate, in eight doses. Diarrhea occurred in 9 of the 16 (56%) subjects receiving placebo and in 2 of the 15 (13%) subjects receiving bismuth subsalicylate, p less than 0.03. This study confirms the effectiveness of bismuth subsalicylate in preventing traveler's (enterotoxigenic E. coli) diarrhea, and shows that bismuth subsalicylate in other than liquid form is effective. Enterotoxigenic E. coli were recovered less frequently from those receiving bismuth subsalicylate than from those receiving placebo, suggesting that bismuth subsalicylate prevents diarrhea by reducing the number or multiplication of enterotoxigenic E. coli. In vitro studies revealed that bismuth subsalicylate and its components each were bactericidal at concentrations possibly attained during the clinical trial.

Topics: Antidiarrheals; Bismuth; Diarrhea; Double-Blind Method; Escherichia coli Infections; Feces; Female; Humans; Male; Organometallic Compounds; Random Allocation; Salicylates; Travel

The efficacy of a daily dosage regimen of subsalicylate bismuth in preventing or reducing the severity of diarrhea among young healthy adults was evaluated in a double-blind, randomized, placebo-controlled trial. Diarrhea developed in 14 (23%) of 62 students receiving subsalicylate bismuth compared with 40 (61%) of 66 students taking a placebo. The protective effect of subsalicylate bismuth was apparent within a day or two of the study onset and became more obvious as the number of days at risk increased. The students treated with subsalicylate bismuth experienced fewer intestinal complaints and were less likely to pass soft or watery stools of any number. Once diarrhea occurred, enteropathogens were less commonly identified in stools of students receiving subsalicylate bismuth (33%) compared with placebo (71%). Subsalicylate bismuth was well tolerated by students during the 21-day trial.

Topics: Adult; Bismuth; Clinical Trials as Topic; Diarrhea; Escherichia coli Infections; Humans; Mexico; Organometallic Compounds; Salicylates; Travel; United States

Students attending a Mexican university who developed diarrhea were randomly treated with bismuth subsalicylate or a placebo. One hundred and eleven were given 30 ml each 1/2 hr until eight doses (total dose of active drug 4.2 g) were given and 58 students received twice this dose (8.2 g of active drug) over the 3 1/2-hr treatment period. The number of unformed stools was significantly decreased in both bismuth subsalicylate treatment groups compared to the placebo controls for the period 4 to 24 hr after therapy. A reduction in diarrhea was additionally noted for the duration of the 48-hr surveillance period for the students receiving the higher dose of active drug. Subjective relief within 24 hr of therapy of the symptoms of diarrhea, nausea, and abdominal pain or cramps was reported with a significantly increased frequency in the bismuth subsalicylate group. The most pronounced effect of the treatment occurred in the United States students with diarrhea who had recently arrived in Mexico. This appeared to be related to the favorable effect of bismut subsalicylate on the course of toxigenic Escherichia coli infection. Students with shigellosis did not experience a prolonged illness in either treatment group.

Topics: Bismuth; Clinical Trials as Topic; Diarrhea; Drug Combinations; Dysentery, Bacillary; Escherichia coli Infections; Humans; Mexico; Placebos; Salicylates; Students

Topics: Anti-Bacterial Agents; Antidiarrheals; Antiprotozoal Agents; Bismuth; Campylobacter Infections; Dysentery; Enteropathogenic Escherichia coli; Escherichia coli; Escherichia coli Infections; Giardiasis; Humans; Loperamide; Multiplex Polymerase Chain Reaction; Organometallic Compounds; Salicylates; Shiga-Toxigenic Escherichia coli; Travel-Related Illness

This experiment was conducted to evaluate the effect of Bacillus subtilis (BS) on broiler performance and health after intramuscular inoculation with E. coli and compare its effect with a growth promoter antibiotic. In a completely randomized design manner, 360 male Ross 308 chicks were divided into 6 treatments and 5 replicates of 12 chicks in each replicate. Experimental treatments included control diet, control + E. coli (0.5 mL of culture containing 108 CFU of E. coli/ml), control + 0.1% BS, control + 0.05% bacitracin methylene disalicylate (BMD), control + E. coli and BS, and control + E. coli and BMD in a factorial arrangement (3 × 2). Addition of BMD or BS to the control diet significantly (P < 0.01) increased body weight and decreased FCR, but E. coli challenge adversely reduced (P < 0.01) body weight and increased FCR, so that the addition of BMD or BS did not compensate growth reduction. E. coli challenged chicks had the lowest vaccine titers for ND, IB, AI, and IBD and the highest were observed in chicks fed BS. The E. coli challenge significantly (P < 0.01) increased albumin, globulin, cholesterol, triglyceride, LDL, ALT, and ALP indices. Addition of BMD and BS decreased albumin and globulin in challenged chick's plasma but had no effect on plasma lipid profile concentration. The E. coli challenge decreased villus height and increased crypt depth and goblet cell numbers significantly (P < 0.01). In birds subjected to BMD or BS, crypt depth decreased and villus height increased (P < 0.01), compared with the control diet. Challenge of E. coli significantly (P < 0.01) increased the bacterial population of E. coli, coliforms, and Salmonella in cecal parts of broilers' intestines. In challenged birds receiving BMD or BS, E. coli, coliform, and Salmonella populations of ceca showed a significant (P < 0.01) reduction. Both BMD and BS increased the digestibility of nutrients significantly (P < 0.01), but a reduction was observed in E. coli challenged groups. Results of the study suggest that spore-forming probiotics are partially effective in unsuitable rearing situations such as colibacillosis in which the load of harmful bacteria is high.

Topics: Animal Feed; Animals; Anti-Bacterial Agents; Bacillus subtilis; Bacitracin; Body Weight Maintenance; Chickens; Diet; Escherichia coli; Escherichia coli Infections; Gastrointestinal Microbiome; Male; Poultry Diseases; Probiotics; Salicylates; Vaccination

Travelers' diarrhea is the most common health impairment in persons visiting developing countries, affecting 20% to >50% of tourists. Although it is usually benign, travelers' diarrhea represents a considerable socioeconomic burden for both the traveler and the host country. The most common enteropathogens are enterotoxigenic and enteroaggregative Escherichia coli. Travelers' compliance with dietary precautionary measures is poor. Despite the excellent protection rates provided by antibiotics, routine administration of prophylaxis is currently not recommended because of potential adverse reactions. Of the various antibiotics that have been tested, quinolones are considered to be the first choice worldwide; however, quinolone-resistant pathogens are increasingly being isolated. Because it is frequently administered and provides only moderate protection, bismuth subsalicylate is not considered a recommendable option for prophylaxis in Europe, where it is rarely available anyhow. To date, no probiotic has been able to demonstrate clinically relevant protection worldwide. In conclusion, there is no satisfactory prophylactic option, and worldwide monitoring of antimicrobial susceptibility patterns and the search for novel antimicrobial agents, such as nonabsorbed antibiotics, and nonantibiotic medications should continue.

Topics: 4-Quinolones; Anti-Infective Agents; Antibiotic Prophylaxis; Bismuth; Diarrhea; Escherichia coli Infections; Humans; Organometallic Compounds; Probiotics; Salicylates; Travel

Each year, more than one million American travelers develop diarrhea, usually due to toxin-producing Escherichia coli. Traveler's diarrhea can be prevented with bismuth subsalicylate or doxycycline, but neither is suitable for pediatric patients. Trimethoprim-sulfamethoxazole is effective for prophylaxis and treatment in adults. It is also safe for children and may prove to be efficacious. It may be possible to avoid widespread prophylaxis and to give medication only if diarrhea develops.

Topics: Bismuth; Child; Diarrhea; Doxycycline; Drug Combinations; Escherichia coli Infections; Humans; Organometallic Compounds; Premedication; Salicylates; Sulfamethoxazole; Travel; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Bismuth; Diarrhea; Doxycycline; Drug Combinations; Escherichia coli Infections; Humans; Organometallic Compounds; Salicylates; Sulfamethoxazole; Travel; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

The processes concerned with the production and loss of body heat in sodium salicylate or acetylsalicylic acid antipyresis were investigated in adult rabbits at an ambient temperature of 21.5 +/- 0.5 degrees C. The experimental fever elicited by i.v. injection of lipopolysaccharide Escherichia coli (1 microgram/kg) was accompanied by increases in O2 consumption and CO2 production as well as decreases in convective heat loss. Pretreatment with 200 mg/kg of sodium salicylate (an hour's i.v. infusion) or with the same dose of acetylsalicylic acid (per os) significantly reduced pyrogen fever but the magnitude of O2 consumption and CO2 production remained at least at the febrile level. In the case of sodium salicylate, the level was even exceeded. At the same time both salicylates activated heat dissipation as manifested by decreases in vasomotor tone and tachypnea. Thus, it is apparent that the antipyretic effect of salicylates may develop without the inhibition of heat production. Heat loss processes initiated by these drugs are responsible for the antipyresis.

Topics: Animals; Body Temperature; Body Temperature Regulation; Carbon Dioxide; Escherichia coli Infections; Lipopolysaccharides; Male; Oxygen Consumption; Rabbits; Respiration; Salicylates; Skin Temperature; Time Factors

Topics: Bismuth; Diarrhea; Escherichia coli Infections; Humans; Salicylates; Travel

Acetylsalicylic acid (ASA) was administered by oral route to calves and mice. A comparison of plasma levels of salicylates and salicyluric acid was performed in healthy and diarrhoic calves. The calves were infected with E. coli enterotoxin producing strains. During the 6 h observation period increased levels of salicylates were found in all age groups of calves (1-60 days). There were no significant differences in salicyluric acid plasma levels between controls and diarrhoic animals. Intravenous injection of cholera toxin in mice caused lower levels of total salicylates, but increased levels of salicylic acid and salicyluric acid. The importance of adequate animal model is discussed.

Topics: Animals; Animals, Newborn; Aspirin; Cattle; Cattle Diseases; Cholera Toxin; Diarrhea; Escherichia coli Infections; Mice; Salicylates; Time Factors

Four adsorbant drug preparations, Kaopectate, colloidal Attapulgite, noncolloidal Attapulgite and Pepto-bismol were investigated for their effects on fluid accumulation in ligated segments of pig intestine inoculated with enteropathogenic Escherichia coli. Two anti-inflammatory drugs. aspirin and methylprednisolone, and two antibiotics, lincomycin and polymyxin B, were also tested. All the drugs except the two anti-inflammatory products were given by injection into the lumen of the intestine. Aspirin was given orally and methylprednisolone was given intramuscularly. The antibiotics were tested at levels at which they had no significant antibacterial effect in in vitro tests. The adsorbant drugs colloidal Attapulgite and Pepto-bismol were shown to be effective in reducing fluid accumulation in ligated segments of pig intestine infected with enteropathogenic E. coli. In the case of Peptobismol this effect was associated with an antibacterial effect as well as an antitoxic effect, probably due to its adsorbant properties. It is possible that an aspirin-like effect in the gut due to the active ingredient bismuth subsalicylate may have contributed to the effectiveness of Pepto-bismol. Colloidal Attapulgite was demonstrated to have an antitoxic effect but did not have an antibacterial effect. In high doses, the anti-inflammatory drugs acetylsalicylic acid and methylprednisolone were marginally effective in reduction of fluid accumulation in the same test system. Lincomycin was shown to reduce intestinal fluid secretion, whereas polymyxin B had no effect.

Topics: Animals; Anti-Inflammatory Agents; Antidiarrheals; Aspirin; Bismuth; Enterotoxins; Escherichia coli; Escherichia coli Infections; Intestinal Secretions; Jejunum; Kaolin; Ligation; Lincomycin; Methylprednisolone; Organometallic Compounds; Pectins; Polymyxin B; Salicylates; Swine; Swine Diseases

Endotoxin [lipopolysaccharide (LPS)] from four Gram-negative bacteria injected i.v. delayed absorption of drugs administered in solution by gastric tube to mice and rats. Salicylate and guinine absorption was delayed at LPS doses from 50 to 400 mug/kg. Salicylate absorption was delayed by LPS when drug was given by gastric tube, while LPS did not affect drug levels when salicylate was given i.p. or intraduodenally. Bethanechol prevented the LPS effect and LPS pretreatment also protected against delayed absorption. LPS- treated rats retained more drugs in their stomachs after 30 minutes and their plasma salicylate levels were lowered. Everted intestinal sacs from LPS-treated rats transferred salicylate as well as controls. Thus, LPS delays gastrointestinal drug absorption solely by retarding gastric emptying. Escherichia coli urinary tract infection did not reproduce LPS delay of drug absorption, but the effects of systemic bacteria were similar to those of endotoxemia.

Topics: Animals; Bacteria; Bethanechol Compounds; Duodenum; Endotoxins; Escherichia coli Infections; Intestinal Absorption; Lipopolysaccharides; Male; Mice; Polysaccharides, Bacterial; Quinine; Rats; Salicylates; Sepsis; Species Specificity; Time Factors; Toxemia; Urinary Tract Infections

Topics: Animals; Complement System Proteins; Escherichia coli Infections; Ethanol; Male; Rabbits; Salicylates; Urinary Bladder; Urinary Bladder Calculi