trimethoprim--sulfamethoxazole-drug-combination and Gastroenteritis

Cyclospora cayetanensis, a coccidian parasite that causes protracted, relapsing gastroenteritis, has a short recorded history. In retrospect, the first 3 documented human cases of Cyclospora infection were diagnosed in 1977 and 1978. However, not much was published about the organism until the 1990s. One of the surprises has been the fact that a parasite that likely requires days to weeks outside the host to become infectious has repeatedly caused foodborne outbreaks, including large multistate outbreaks in the United States and Canada. In this review, I discuss what has been learned about this enigmatic parasite since its discovery and what some of the remaining questions are. My focus is the foodborne and waterborne outbreaks of cyclosporiasis that were documented from 1990 through 1999. The occurrence of the outbreaks highlights the need for health care personnel to consider that seemingly isolated cases of infection could be part of widespread outbreaks and should be reported to public health officials. Health care personnel should also be aware that stool specimens examined for ova and parasites usually are not examined for Cyclospora unless such testing is specifically requested and that Cyclospora infection is treatable with trimethoprim-sulfamethoxazole.

Topics: Animals; Canada; Cyclospora; Cyclosporiasis; Disease Outbreaks; Feces; Food Parasitology; Foodborne Diseases; Fruit; Gastroenteritis; Humans; Trimethoprim, Sulfamethoxazole Drug Combination; United States; Water

Listeria monocytogenes has become a major pathogen in foodborne illness. It most often affects patients who are pregnant, at the extremes of life, or immunocompromised in some way. A variety of clinical manifestations are possible, but bacteremia and meningitis are most common. This article reviews the epidemiology, microbiology, populations at risk, clinical manifestations, treatment, and prevention of listeriosis.

Topics: Adolescent; Adult; Age Distribution; Aged; Ampicillin; Bacteremia; Child; Child, Preschool; Endocarditis; Erythromycin; Female; Foodborne Diseases; Gastroenteritis; Humans; Incidence; Infant; Infant, Newborn; Listeria monocytogenes; Listeriosis; Male; Meningitis; Middle Aged; Pregnancy; Pregnancy Complications, Infectious; Survival Rate; Trimethoprim, Sulfamethoxazole Drug Combination; Vancomycin

At the Clinic for infectious and dermatovenerologic diseases in Novi Sad a prospective randomized, simple, blind investigation of differently organized treatments of salmonellal gastroenterocolitis (symptomatic therapies, ampicillin, co-trimoxazole and ciprofloxacine) was carried out. It was established that there is no statistically significant difference in the length of febrile states in any of the compared therapeutic groups. However, ciprofloxacine significantly shortens diarrhea and excretion of germs comparing with other therapeutic treatments.

Topics: Adolescent; Adult; Ampicillin; Anti-Infective Agents; Child; Child, Preschool; Ciprofloxacin; Colitis; Female; Gastroenteritis; Humans; Infant; Male; Middle Aged; Penicillins; Prospective Studies; Salmonella Infections; Single-Blind Method; Trimethoprim, Sulfamethoxazole Drug Combination

The comparative efficacy of antibacterial therapy with pivmecillinam or cotrimoxazole and general supportive care only was studied in patients with severe bacterial gastroenteritis. Overall, treatment with antibiotics proved significantly superior to rehydration alone in 42 children. Active therapy also had a statistically beneficial effect in children infected with Vibrio cholerae and V. parahaemolyticus. Pivmecillinam and co-trimoxazole were equally effective. Pivmecillinam and oral mecillinam appeared to be of equal value in a further 22 adults infected by Vibrio spp. No side-effects were recorded in any of the subjects treated. Further investigations with pivmecillinam and oral mecillinam are advocated.

Topics: Adult; Amdinocillin; Amdinocillin Pivoxil; Child, Preschool; Cholera; Drug Combinations; Enterobacteriaceae Infections; Gastroenteritis; Humans; Penicillanic Acid; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Vibrio Infections; Vibrio parahaemolyticus

Topics: Adolescent; Child; Child, Preschool; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Feces; Female; Gastroenteritis; Humans; Infant; Male; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Yersinia enterocolitica; Yersinia Infections

Increasing access to rapid diagnostic tests for malaria (mRDTs) has raised awareness of the challenges healthcare workers face in managing non-malarial febrile illnesses (NMFIs). We examined NMFI prevalence, clinical diagnoses, and prescribing practices in outpatient clinics across different malaria transmission settings in Malawi. Standardized facility-based malaria surveillance was conducted at three facilities one of every 4 weeks over 2 years. Information on demographics, presenting symptoms, temperature, clinical diagnosis, and treatment were collected from outpatients presenting with malaria-like symptoms. Of the 25,486 patients with fever, 69% had NMFI. Non-malarial febrile illness prevalence was lower in 5- to 15-year-old patients (55%) than in children < 5 years (72%) and adults > 15 years of age (77%). The most common clinical diagnoses among febrile patients with negative mRDTs in all age-groups and settings were respiratory infections (46%), sepsis (29%), gastroenteritis (13%), musculoskeletal pain (9%), and malaria (5%). Antibiotic prescribing was high in all age-groups and settings. Trimethoprim-sulfamethoxazole (40%) and amoxicillin (29%) were the most commonly prescribed antibiotics and were used for nearly all clinical diagnoses. In these settings with minimal access to diagnostic tools, patients with fever and a negative mRDT received a limited number of clinical diagnoses. Many were likely to be inaccurate and were associated with the inappropriate use of the limited range of available antibiotics. Prescription and diagnostic practices for NMFIs in the facilities require research and policy input. Resource-limited malaria-endemic countries urgently need more point-of-care diagnostic tools and evidence-based diagnosis and treatment algorithms to provide effective and cost-efficient care.

Topics: Adolescent; Ambulatory Care; Amoxicillin; Anti-Bacterial Agents; Child; Child, Preschool; Disease Management; Endemic Diseases; Female; Fever; Gastroenteritis; Humans; Malaria; Malawi; Male; Musculoskeletal Pain; Prevalence; Respiratory Tract Infections; Sepsis; Soft Tissue Infections; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

Topics: CD8-Positive T-Lymphocytes; Child, Preschool; Drug Eruptions; Gastroenteritis; Humans; Keratinocytes; Male; Skin; Skin Tests; Trimethoprim, Sulfamethoxazole Drug Combination

There is limited information available regarding the etiology of gastrointestinal infections in Burkina Faso. The aim of this study was to investigate the prevalence and epidemiology of enteric pathogens causing gastroenteritis in young children, with a focus on rotavirus, and to investigate the levels of malnutrition and other clinical factors in association with the severity of diarrhea.. A prospective study was undertaken from May 2009 to March 2010, covering the rainy and dry seasons, at the Saint Camille Medical Center in Ouagadougou, Burkina Faso. A total of 309 children less than 5 years of age with diarrhea were enrolled and examined for rotavirus, bacterial, and parasitic infections, as well as clinico-epidemiological aspects.. At least one enteropathogen was detected in 57.9% (n=179) of the children. Of these, 32.4% had rotavirus infections, 16.8% bacterial infections (enteropathogenic Escherichia coli 9.7%, Shigella spp 5.8%, and Salmonella spp 2.3%), and 18.8% parasitic infections (Giardia lamblia 11.3%, Trichomonas intestinalis 6.8%, Entamoeba histolytica/dispar 1.3%). During the cold dry period from December 2009 to February 2010, we observed a large increase in diarrhea cases, which was mainly attributed to rotavirus infections, as 63.8% of these diarrhea cases were positive for rotavirus. In contrast, no rotavirus infection was observed during the rainy season (June-September 2009), when the frequency of parasitic infections was high. Rotavirus and parasitic infections were age-related, with rotavirus being more prevalent in young children (<12 months) and parasites more common in older children (>12 months), while bacteria were equally prevalent among all age groups. Rotavirus infections exhibited more severe symptoms compared to bacteria and parasites, and were associated with fever, vomiting, and severe dehydration. Malnutrition, especially acute malnutrition (wasting), was significantly associated with more severe symptoms in rotavirus-induced diarrhea. The undernourished children also exhibited a prolonged duration of diarrheal episodes.. This study demonstrates rotavirus as the main etiological agent in pediatric diarrhea in Burkina Faso, and further shows the great severity of rotavirus-induced diarrhea in undernourished children in Burkina Faso.

Topics: Age Factors; Anti-Infective Agents; Bacterial Infections; Burkina Faso; Child, Preschool; Diarrhea; Drug Resistance, Bacterial; Female; Gastroenteritis; Humans; Infant; Male; Malnutrition; Parasitic Diseases; Prevalence; Rotavirus Infections; Seasons; Trimethoprim, Sulfamethoxazole Drug Combination

The aim of this study was to define the epidemiological, clinical, and antibiotic susceptibility patterns of Shigella gastroenteritis cases occurring during the years 2003-2009 and to compare results with those of the years 1987-2002.. A hospital-based study was conducted over a 22-year period. All 238 Shigella strains isolated between 2003 and 2009 were compared to 618 isolates from the period 1987-1994 and 218 Shigella strains isolated during 1995-2002 with regard to antimicrobial resistance patterns and patient clinical characteristics.. The predominant species during all periods was Shigella sonnei, with an increasing predominance across the periods (64.0%, 71.5%, and 87.8%, respectively; p<0.001). Neither the prevalence of bloody diarrhea nor other clinical characteristics changed across the study periods, except for the prevalence of dehydration, which increased (11.0%, 20.6%, and 28.6%, respectively; p<0.001). During the period 2003-2009, 69.9% of Shigella were resistant to trimethoprim/sulfamethoxazole, 35.8% to ampicillin, and 4.7% to nalidixic acid. No case resistant to ciprofloxacin was detected. Multidrug resistance was also found to be similar in the last two periods (24.0% vs. 28.1%, respectively).. There was both a microbiological and a clinical change in childhood Shigella gastroenteritis cases over the 22 years. The antibiotic resistance pattern appears to have remained stable over the last two periods. There is a need to re-examine the criteria and clinical management guidelines for suspected shigellosis cases.

Topics: Adolescent; Ampicillin; Anti-Bacterial Agents; Child; Child, Preschool; Cross Infection; Dehydration; Drug Resistance, Multiple, Bacterial; Dysentery, Bacillary; Female; Gastroenteritis; Humans; Infant; Male; Microbial Sensitivity Tests; Nalidixic Acid; Prevalence; Shigella; Shigella sonnei; Trimethoprim, Sulfamethoxazole Drug Combination; Turkey

Cyclospora spp. which are coccidian parasites are rare gastroenteritis pathogens. The first cyclosporiasis case in Turkey was reported in 1998 in a patient with AIDS. In this paper we report a case of Cyclospora gastroenteritis, in a patient who was admitted to our hospital and who had had diarrhea, abdominal pain and nausea for ten days. In the anamnesis it was learned that he had travelled to the Black Sea region and had drunk muddy and cloudy water. His physical examination was normal except for increased bowel sounds. There were no leukocytes or erythrocytes in the direct microscopy of the stool and bacteriologic culture did not yield any enteropathogen. Cylospora oocyysts were seen in the parasitologic exmination. The patient was treated with cotrimaxasole (2x1,160/800 mg tablet). There was no pathogen in the repeated stool examination. Our case suggests that parasitologic examination should not be neglected in longlasting diarrhea cases and occasionally Cyclospora may be the causative agent.

Topics: Abdominal Pain; Adult; Anti-Infective Agents; Cyclospora; Cyclosporiasis; Diarrhea; Female; Gastroenteritis; Humans; Nausea; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adolescent; Bacteremia; Bacterial Proteins; Campylobacter Infections; Campylobacter jejuni; DNA Gyrase; Drug Resistance, Microbial; Gastroenteritis; Humans; Male; Mutation, Missense; Nalidixic Acid; Pakistan; Salmonella typhi; Trimethoprim, Sulfamethoxazole Drug Combination; Typhoid Fever

During an outbreak of acute Salmonella braenderup gastroenteritis we performed a standardised interview encompassing questions on clinical symptoms in 156 (127 adults and 29 children) of 215 identified patients. Sequential stool cultures were obtained for up to five months in these 156 cases. We restricted the analysis to the 122 patients with at least 3 or more available cultures. They were treated with a fluoroquinolone, trimethoprim-sulfamethoxazole, or not treated with antibiotics, according to the decision of the practitioners. For this reason, a randomised double blind study was not possible. Minimum inhibitory concentrations (MIC) of the prescribed drugs were measured for representative isolates before and after treatment. The most frequent symptoms were diarrhoea (98%) and abdominal pain (96%). Vomiting occurred in 43% of cases. Children were more severely ill. Seven weeks after acute gastroenteritis, stool cultures were still positive for salmonella in 71% of the 22 children and 30% of the 100 adults examined (p < 0.002). This rate decreased progressively in both groups to 5 and 3% respectively at 20 weeks (n.s.). Among adults, no significant difference in enteric carriage over time could be demonstrated between untreated patients and those treated with either a fluoroquinolone or trimethoprim-sulfamethoxazole. MIC for salmonella isolates remained unchanged after treatment. In a cohort of patients infected with a single strain of salmonella, fluoroquinolone therapy of acute gastroenteritis failed to influence the duration of enteric carriage, despite continuing susceptibility of the strain. In children, the rate of clearance of Salmonella braenderup from stool was statistically lower until the tenth week after the acute disease, but there was no further difference after 5 months.

Topics: Adult; Anti-Infective Agents; Child; Diarrhea; Disease Outbreaks; Fever; Fluoroquinolones; Gastroenteritis; Humans; Salmonella Infections; Switzerland; Trimethoprim, Sulfamethoxazole Drug Combination

To evaluate antimicrobial treatment and resistance in clinical childhood shigellosis.. Retrospective.. St. Elisabeth Hospital, Willemstad, Curaçao, Dutch Antilles.. From September 1991 through August 1995 shigellosis was diagnosed in 93 children out of 456 hospitalised with gastroenteritis (S. flexneri in 60, S. sonnei in 32, S. dysenteriae in 1). From hospital and laboratory records, the clinical presentation, antibiotic treatment and duration of hospitalization were indexed as well as the antibacterial resistance pattern of shigellae.. Of the hospitalised children 52 (56%) were treated with antibiotics. Ampicillin was given most frequently (71%), followed by the combination trimethoprim-sulfamethoxazole (25%). Isolated shigellae were resistant to ampicillin in 52% and to trimethoprim-sulfamethoxazole in 34%; 42% of the antibiotic treatments were in accordance with susceptibility of the isolated Shigella.. A high percentage of shigellae isolated on Curaçao was resistant to the most frequently used antibiotics ampicillin and trimethoprim-sulfamethoxazole.

Topics: Ampicillin; Ampicillin Resistance; Anti-Bacterial Agents; Child; Child, Preschool; Dysentery, Bacillary; Female; Gastroenteritis; Humans; Infant; Male; Netherlands Antilles; Penicillins; Retrospective Studies; Shigella flexneri; Shigella sonnei; Trimethoprim Resistance; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Acute Disease; Child; Child, Preschool; Enterobacteriaceae; Enterobacteriaceae Infections; Feces; Gastroenteritis; Humans; Male; Trimethoprim, Sulfamethoxazole Drug Combination

Under combat conditions infectious disease can become a major threat to military forces. During Operation Desert Shield, there were numerous outbreaks of diarrhea among the U.S. forces. To evaluate the causes of and risk factors for diarrheal disease, we collected clinical and epidemiologic data from U.S. troops stationed in northeastern Saudi Arabia.. Between September and December 1990, stool cultures for enteric pathogens were obtained from 432 military personnel who presented with diarrhea, cramps, vomiting, or hematochezia. In addition, a questionnaire was administered to 2022 soldiers in U.S. military units located in various regions of Saudi Arabia.. A bacterial enteric pathogen was identified in 49.5 percent of the troops with gastroenteritis. Enterotoxigenic Escherichia coli and Shigella sonnei were the most common bacterial pathogens. Of 125 E. coli infections, 39 percent were resistant to trimethoprim-sulfamethoxazole, 63 percent to tetracycline, and 48 percent to ampicillin. Of 113 shigella infections, 85 percent were resistant to trimethoprim-sulfamethoxazole, 68 percent to tetracycline, and 21 percent to ampicillin. All bacterial isolates were sensitive to norfloxacin and ciprofloxacin. After an average of two months in Saudi Arabia, 57 percent of the surveyed troops had at least one episode of diarrhea, and 20 percent reported that they were temporarily unable to carry out their duties because of diarrheal symptoms. Vomiting was infrequently reported as a primary symptom, but of 11 military personnel in whom vomiting was a major symptom, 9 (82 percent) had serologic evidence of infection with the Norwalk virus.. Gastroenteritis caused by enterotoxigenic E. coli and shigella resistant to a number of drugs was a major problem that frequently interfered with the duties of U.S. troops during Operation Desert Shield.

Topics: Adolescent; Adult; Ampicillin; Diarrhea; Drug Resistance, Microbial; Dysentery, Bacillary; Escherichia coli; Escherichia coli Infections; Feces; Gastroenteritis; Humans; Male; Middle Aged; Military Personnel; Norwalk virus; Saudi Arabia; Shigella sonnei; Surveys and Questionnaires; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination; United States; Vomiting; Warfare

To present the findings of Isospora belli infection in two patients with the acquired immunodeficiency syndrome (AIDS).. One patient was part Aboriginal, the other an immigrant recently arrived from Peru. Both men were infected with the human immunodeficiency virus (HIV). They presented with watery diarrhoea, one with severe weight loss. Isospora belli oocysts were detected in multiple faecal specimens from both patients. One patient had a concomitant infection with Cryptosporidium sp.. There was a rapid response to treatment with cotrimoxazole (960 mg, four times a day for 10 days). A complete response was obtained in the patient with concurrent cryptosporidiosis. The diarrhoea recurred after cessation of treatment, necessitating maintenance therapy.. Although Isospora belli is an uncommon cause of gastroenteritis in Australia, it is increasingly recognised as a cause of diarrhoea in travellers, immigrants from endemic areas and immunocompromised people. It has also been reported in the Aboriginal community; this article reports the first case of AIDS-related isosporiasis in an Aborigine. It is likely that both patients acquired Isospora belli before they become HIV seropositive.

Topics: Acquired Immunodeficiency Syndrome; Adult; Coccidiosis; Cryptosporidiosis; Diarrhea; Gastroenteritis; Humans; Male; Trimethoprim, Sulfamethoxazole Drug Combination

One week after treatment of a urinary infection with co-trimoxazole (twice daily 160 mg trimethoprim and 800 mg sulphamethoxazole) a 21-year-old man suddenly started to vomit, accompanied by watery diarrhoea, abdominal swelling and weight loss of 5 kg. Plain X-ray film of the abdomen while standing showed multiple fluid levels in the small intestine of the upper and lower abdomen. Serum IgE concentration was elevated to 325 U/ml. There was a leukocytosis of 25,800/microliters, with a differential count of 45% eosinophils. Protein-rich ascites contained numerous eosinophils and the mucosa of the terminal ileus and the duodenum was infiltrated with eosinophils, findings which indicated eosinophilic gastroenteritis. All symptoms regressed completely within 10 days of stopping co-trimoxazole and administering prednisolone (50 mg/day). Four years later a similar episode of eosinophilic gastroenteritis developed after the patient had taken trimethoprim with a sulphonamide (once daily 180 mg trimethoprim and 820 mg sulphadiazine). It again quickly responded to short-term administration of glucocorticoids.

Topics: Adult; Drug Hypersensitivity; Eosinophilia; Gastroenteritis; Humans; Male; Prednisolone; Recurrence; Time Factors; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections

A previously healthy 15-year-old girl fell ill with febrile gastroenteritis; Plesiomonas shigelloides was isolated from the blood 6 h after she had received one tablet of trimethoprim-sulfadiazine on the third day of symptoms. She recovered uneventfully. P. shigelloides may be isolated from the blood in immunocompetent patients with mild, uncomplicated gastroenteritis.

Topics: Adolescent; Female; Gastroenteritis; Humans; Sepsis; Trimethoprim, Sulfamethoxazole Drug Combination; Vibrio Infections; Vibrionaceae

Topics: Ampicillin; Child; Child, Preschool; Drug Combinations; Dysentery, Bacillary; Female; Gastroenteritis; Humans; Infant; Male; Salmonella Infections; Shigella flexneri; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Anti-Infective Agents; Drug Combinations; Female; Gastroenteritis; Humans; Middle Aged; Pancytopenia; Salmonella Infections; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

The role of Yersinia enterocolitica as a human pathogen has been documented in publications from over 30 countries, and Y. enterocolitica has been recognized increasingly to cause gastrointestinal disease in children. In 1979, an Australian survey yielded only three isolates of Y. enterocolitica from 3298 faecal specimens obtained from adults. We screened all stool specimens received during a 22-month period for Yersinia by means of a recently developed selective agar medium. Y. enterocolitica was isolated from 32 of 4136 (0.7%) specimens. Most isolates were of serotype O:3, biotype 4. During the study, 154 Salmonella spp. (3.7%), 196 Campylobacter spp. (47%), seven Shigella spp. (0.2%) and 27 Aeromonas spp. (0.9% of 2779) were recovered. Children infected with Y. enterocolitica presented with acute diarrhoea associated with fever and pharyngitis; chronic or recurrent diarrhoea; or pain in the right iliac fossa associated with mesenteric adenitis. Gastrointestinal symptoms usually resolved spontaneously within two weeks. However, some children were treated successfully with cotrimoxazole.

Topics: Adolescent; Anti-Bacterial Agents; Appendicitis; Child; Child, Preschool; Diagnosis, Differential; Diarrhea; Drug Combinations; Erythromycin; Feces; Female; Gastroenteritis; Humans; Infant; Male; Retrospective Studies; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Yersinia enterocolitica; Yersinia Infections

An outbreak caused by a highly resistant strain of Salmonella typhimurium occurred in a nursery at a university medical center. The outbreak strain, which was resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole, was apparently imported from the Far East by a Cambodian refugee. The five patients involved had severe underlying diseases, and bacteremia and meningitis developed in one of these patients. The only reservoir identified was the gastrointestinal tracts of the infected patients, and infection was probably transmitted by the contaminated hands of hospital personnel. The outbreak was rapidly brought under control by isolating cases outside of the nursery and by instituting enteric precautions for infants who remained in the nursery. When compared by disk diffusion susceptibility tests with 353 strains of S. typhimurium tested at the Centers for Disease Control, the imported strain had a unique antibiogram. Bacteriophage typing of the strains revealed that all were untypable; this, in itself, was a good marker, because only 5 to 10% of S. typhimurium isolates in this country have this property. Agarose gel electrophoresis of isolates from the five patients revealed an identical plasmid banding pattern consisting of three large and three small plasmids. Highly resistant strains of S. typhimurium imported from the Far East may spread rapidly when introduced into a hospital nursery. Prompt institution of control measures may limit the outbreak and prevent systemic infections for which there are few effective therapeutic agents.

Topics: Ampicillin; Bacteriophage Typing; Chloramphenicol; Cross Infection; Disease Outbreaks; Drug Combinations; Gastroenteritis; Humans; Infant; Infant, Newborn; Nurseries, Hospital; Penicillin Resistance; Salmonella Infections; Salmonella typhimurium; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

148 children with Salmonella gastroenteritis were admitted to the Mautner Markhofsches Kinderspital of Vienna in the 4-year period 1977 to 1980. The age distribution showed a marked prevalence of infants and young children. Salmonella Wien, typhi murium and enteritidis were the most commonly found Salmonella subtypes. No complications were encountered. After an average stay in hospital of 9 days the patients were considered fit for discharge, although only one third had negative stool cultures, whilst two thirds were convalescent Salmonella excretors. The duration of Salmonella excretion showed a hyperbolic course and was dependent on various factors, but could not be shortened by antimicrobial treatment. The topical problems of Salmonella gastroenteritis are discussed: the age distribution, with the highest incidence in early childhood, the duration of excretion in relation to antimicrobial treatment, the arguments against routine antibacterial treatment, the increase in Salmonella gastroenteritis in Western countries over the past years and the cause of this increase based on the high contamination rate of meat from animals infected by contaminated fodder. Large canteens are particularly vulnerable.

Topics: Ampicillin; Austria; Carrier State; Child; Child, Preschool; Drug Combinations; Female; Food Contamination; Gastroenteritis; Humans; Infant; Male; Salmonella Infections; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

The local tolerance of a new mode of application of Cotrimoxazole (Eusaprim i.m.) was tested in 104 patients by 12 general practitioners in the region of Northern Bavaria. The patients received 1--2 injections, after which the assessment of local tolerance of the injection was done.. Parameters were the subjective statements by the patients and the objective findings by the physicians. 102 out of 104 patients reported about a good or acceptable tolerance. The physicians found a good tolerance in 99 cases and an average one in 5 patients.

Topics: Abscess; Adolescent; Adult; Aged; Drug Combinations; Female; Gastroenteritis; Humans; Injections, Intramuscular; Male; Middle Aged; Respiratory Tract Infections; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections