trimethoprim--sulfamethoxazole-drug-combination and Enteritis

Topics: Anti-Bacterial Agents; Arthritis, Infectious; Ceftriaxone; Central Nervous System Infections; Doxycycline; Endocarditis, Bacterial; Enteritis; Gentamicins; Humans; Microscopy, Electron, Transmission; Penicillins; Periodic Acid-Schiff Reaction; Polymerase Chain Reaction; Streptomycin; Trimethoprim, Sulfamethoxazole Drug Combination; Tropheryma; Vancomycin; Whipple Disease

Topics: Anti-Infective Agents; Bacterial Infections; Campylobacter Infections; Child; Dysentery, Bacillary; Enteritis; Escherichia coli Infections; Humans; Salmonella Infections; Trimethoprim, Sulfamethoxazole Drug Combination

The role of ciprofloxacin and trimethoprim-sulfamethoxazole (TMP-SMZ) was evaluated in empiric treatment of uncomplicated Salmonella enteritis in a comparative, double-blind trial. Patients were randomized to receive ciprofloxacin (500 mg), TMP-SMZ (160/800 mg), or placebo orally twice daily for 5 days. There were 65 evaluatable patients with acute, uncomplicated, culture-confirmed Salmonella enteritis. Duration of diarrhea, abdominal pain, or vomiting and time to defervescence were not significantly different for patients treated with ciprofloxacin, TMP-SMZ, or placebo; there also were no significant differences with respect to full resolution of symptoms for ciprofloxacin versus placebo (point estimate, 0.2 days; 95% confidence interval [CI], -0.5 to 0.9 days) or for TMP-SMZ versus placebo (point estimate, 0.2 days; 95% CI, -1.0 to 0.6 days). The rate of clearance of salmonellae from stools was not significantly different among the groups.

Topics: Acute Disease; Adult; Ciprofloxacin; Double-Blind Method; Drug Combinations; Enteritis; Feces; Female; Humans; Male; Middle Aged; Salmonella Infections; Trimethoprim, Sulfamethoxazole Drug Combination

We undertook a prospective, controlled study to evaluate the effect of trimethoprim-sulfamethoxazole in children with proven Escherichia coli O157:H7 enteritis on the duration fo symptoms, on fecal excretion of pathogen, and on the risk of progression to hemolytic-uremic syndrome. There was no statistically significant effect of treatment on progression of symptoms, fecal pathogen excretion, or the incidence of HUS (2/22 vs 4/25; p = 0.67). Our results suggest that a multicentric trial using rapid diagnostic methods to permit early randomization should be carried out.

Topics: Child; Child, Preschool; Enteritis; Escherichia coli; Escherichia coli Infections; Feces; Female; Hemolytic-Uremic Syndrome; Humans; Infant; Male; Prospective Studies; Trimethoprim, Sulfamethoxazole Drug Combination

In a prospective randomized study we have evaluated the influence of co-trimoxazole and mecillinam on the clinical outcome and the fecal Salmonella sp carrier status in 134 adult patients with acute non-typhi Salmonella sp enteritis. The patients were distributed in three groups on the basis of predefined clinical and biological criteria, depending on their risk of bacteremia or severe complications of it, or on the enteroinvasive character of the causative organism. The inclusion in any group determined the treatment. Seventy-six patients received mecillinam (1.200 mg/day p.o.), 36 co-trimoxazole (1.600 mg/day p.o.), both during five days, and 22 only diet. The patients were investigated after 1, 3 and 6 weeks until stool culture was negative. The isolated Salmonella strains, either in stool or blood culture, had a sensitivity of 98.3% to mecillinam and 96.9% to cotrimoxazole. Resistance did not develop during therapy. All patients had a favorable outcome, including the six with bacteremia. No differences were found regarding clinical features (diarrhea, abdominal pain, fever) or the rate of positive stool cultures in the three therapeutic groups in any of the follow-up controls. It was concluded that the administration of mecillinam or co-trimoxazole to patients with Salmonella sp enteritis is not associated with a prolongation of the state of fecal carrier or with the development of resistant strains.

Topics: Adult; Amdinocillin; Carrier State; Drug Evaluation; Drug Resistance, Microbial; Enteritis; Humans; Prospective Studies; Random Allocation; Salmonella Infections; Trimethoprim, Sulfamethoxazole Drug Combination

Isospora belli infection, characterized by peripheral blood eosinophilia, is often seen as an opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS). It is also reported in patients with underlying lymphoproliferative disorders including lymphoma and leukemia. Eosinophil-associated gastrointestinal disorders (EGID), including eosinophilic gastroenteritis (EGE), is characterized by eosinophilic infiltration of the gastrointestinal (GI) tract with various GI symptoms. We report a case of a 50-year-old male who developed Isospora superinfection of the small bowel while receiving systemic corticosteroids for EGE. He presented with worsening diarrhea, abdominal pain, nausea and vomiting with worsening peripheral eosinophilia. I. belli infection was diagnosed by the detection of oocysts in stool samples and by the presence of the parasite on duodenal biopsy in the background of tissue eosinophilia. I. belli can cause severe chronic diarrhea in immunocompromised patients on corticosteroids. Trimethoprim-sulfamethoxazole often provided rapid cure. Even though peripheral blood eosinophilia was seen in both EGE and Isospora infection, the identification of subnuclear protozoal inclusions as a new histologic finding, as well as the absence of this finding in previous duodenal biopsies coupled with the continued presence of tissue eosinophilia, favored a parasitic superinfection in the setting of underlying EGE.

Topics: Animals; Biopsy; Duodenum; Enteritis; Eosinophilia; Feces; Gastritis; Humans; Isospora; Isosporiasis; Male; Middle Aged; Superinfection; Trimethoprim, Sulfamethoxazole Drug Combination

Trimethoprim/sulfamethoxazole is widely used in the treatment of infectious diseases caused by bacterial pathogens in aquaculture. However, the practice of antibiotic administration can promote the emergence of resistant strains of bacteria and result in a wane in efficacy over time. The objective of this study was to assess the effect of oral treatment with trimethoprim/sulfamethoxazole on the gastrointestinal (GI) microbiota of healthy gibel carp and those affected with bacterial enteritis. By using denaturing gradient gel electrophoresis (DGGE), the changes in the predominant bacterial communities were directly depicted for the first time. The main findings were (1) Actinobacteria, Firmicutes and Proteobacteria were the predominant phyla in the healthy gibel carp intestine; (2) administration of antibiotics had a more profound impact on the intestinal microflora of healthy fish than of the diseased ones; and (3) Enterobacteriaceae might be one of the major drug-resistant bacteria in the gibel carp intestine. This study provides an insight into the effect of antibiotic treatment on the establishment and colonization of fish GI microbiota and speculates on some possible drug-resistant bacteria.

Topics: Administration, Oral; Animals; Bacteria; Bacterial Infections; Denaturing Gradient Gel Electrophoresis; Enteritis; Fish Diseases; Gastrointestinal Tract; Goldfish; RNA, Bacterial; RNA, Ribosomal, 16S; Trimethoprim, Sulfamethoxazole Drug Combination

A 27-year-old man who had a history of bronchial asthma, eosinophilic enteritis, and eosinophilic pneumonia presented with fever, skin eruptions, cervical lymphadenopathy, hepatosplenomegaly, atypical lymphocytosis, and eosinophilia two weeks after receiving trimethoprim (TMP)-sulfamethoxazole (SMX) treatment. After the withdrawal of TMP-SMX and the administration of high-dose steroid, these systemic symptoms gradually resolved. During the disease course, the patient showed a transient increase in anti-human herpesvirus (HHV)-6 antibody titers and HHV-6 DNA in the peripheral blood, indicating the reactivation of a latent HHV-6 infection. This is the first case of TMP-SMX-induced hypersensitivity syndrome associated with the reactivation of a latent viral infection.

Topics: Adult; Anti-Bacterial Agents; Antibiotic Prophylaxis; Antibodies, Viral; Asthma; DNA, Viral; Drug Eruptions; Enteritis; Glucocorticoids; Herpesvirus 6, Human; Humans; Male; Opportunistic Infections; Pulmonary Eosinophilia; Recurrence; Roseolovirus Infections; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Virus Activation

We describe a fatal case of haemolytic uraemic syndrome in a young woman with AIDS, and disseminated adenovirus (ADV) and cytomegalovirus (CMV) co-infection. We hypothesize that ADV/CMV co-infection may have a causative role in this clinical picture.

Topics: Acquired Immunodeficiency Syndrome; Acute Kidney Injury; Adenovirus Infections, Human; Colitis; Cytomegalovirus Infections; Enteritis; Fatal Outcome; Female; Foscarnet; Ganciclovir; Hemolytic-Uremic Syndrome; Humans; Respiratory Distress Syndrome; Trimethoprim, Sulfamethoxazole Drug Combination

According to the "International Passenger Survey," published in 1996 by the Office of Trading Standards, 534,000 British people traveled to the Caribbean area (personal communication, ABTA, 1998). The Dominican Republic, the eastern end of a large Caribbean island, has become in recent years one of the most popular destinations for UK holidaymakers as well as for travelers from many other countries. Cyclospora cayatensis has been firmly identified as a cause of gastroenteritis among international travelers,1 including human immunodeficiency virus (HIV)-positive individuals,2 but it has not been previously reported in the literature in British individuals returning from this increasingly popular vacation destination.

Topics: Aged; Animals; Anti-Infective Agents; Coccidiosis; Diagnosis, Differential; Diarrhea; Dominican Republic; Eimeriida; England; Enteritis; Feces; Female; Humans; Male; Travel; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adolescent; Adult; Anti-Bacterial Agents; Bacteremia; beta-Thalassemia; Ceftriaxone; Cephalosporins; Child; Child, Preschool; Enteritis; Female; Humans; Infant; Male; Prospective Studies; Trimethoprim, Sulfamethoxazole Drug Combination; Yersinia enterocolitica; Yersinia Infections

Yersinia enterocolitica enteritis is a potentially treatable infection. To understand its seasonal incidence and clinical presentation in children, we reviewed case records of children seen in Cardinal Glennon Children's Hospital in St. Louis, MO. We found the incidence of Yersinia enteritis to be as frequent as enteritis caused by Campylobacter. It occurred more frequently during the winter months (P < 0.002) than during the rest of the year. Fever was common in infants with Yersinia enteritis. Abdominal pain and distention were infrequent. Seventeen (35%) patients were 3 months of age or younger; 4 of 17 (28%) developed Yersinia sepsis as a complication of the enteritis. Physicians should perform stool cultures for Y. enterocolitica in young infants who present with high fever and diarrhea in winter months, especially when there is blood in stools or the patient appears septic.

Topics: Age Factors; Cefotaxime; Child; Child, Preschool; Diarrhea; Enteritis; Feces; Female; Gentamicins; Hospitalization; Humans; Incidence; Infant; Infant, Newborn; Male; Missouri; Retrospective Studies; Seasons; Trimethoprim, Sulfamethoxazole Drug Combination; Yersinia enterocolitica; Yersinia Infections

Topics: Amdinocillin; Carrier State; Enteritis; Humans; Salmonella Infections; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Acquired Immunodeficiency Syndrome; Coccidiosis; Drug Hypersensitivity; Enteritis; Humans; Male; Middle Aged; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Acquired Immunodeficiency Syndrome; Adult; Coccidiosis; Drug Combinations; Enteritis; Humans; Male; Stevens-Johnson Syndrome; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

The bacteriologic and clinical effects of early antibiotic treatment of Campylobacter jejuni enteritis were studied. Erythromycin rapidly eliminated C. jejuni from stools, whereas trimethoprim-sulfamethoxazole did not. Despite its bacteriologic effectiveness, erythromycin did not reduce the duration or severity of diarrhea, abdominal pain, or other symptoms.

Topics: Adult; Campylobacter fetus; Campylobacter Infections; Child; Drug Combinations; Enteritis; Erythromycin; Feces; Female; Humans; Male; Microbial Sensitivity Tests; Sulfamethoxazole; Time Factors; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Three cases are reported of salmonella aortitis observed in three men aged 55, 60 and 48 years, the last of whom had a prosthetic aortic valve and ascending aorta. The microorganisms were S. typhi murium, S. paratyphi B, and S. wien. Despite antibiotic treatment two patients died of perforating aortitis. The third patient developed S. wien gastroenteritis a few days after surgical replacement of the aortic valve and the ascending aorta. Five years later he presented with several bacteremic episodes due to S. wien, which recurred despite several courses of cotrimoxazole treatment. He has now been asymptomatic for over one year under prolonged cotrimoxazole treatment. Since vascular infection may occur following non typhi salmonellosis in 5% of patients over 50, or who have underlying endothelial lesions, the question arises as to whether non typhi S. gastroenteritis should be treated with antibiotics in these high risk patients, in contrast to present recommendations.

Topics: Ampicillin; Aortitis; Drug Combinations; Enteritis; Humans; Male; Middle Aged; Salmonella; Salmonella Infections; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination