trimethoprim--sulfamethoxazole-drug-combination and Intestinal-Diseases

Coccidial parasites of the genus Isospora cause intestinal disease in several mammalian host species. These protozoal parasites have asexual and sexual stages within intestinal cells of their hosts and produce an environmentally resistant cyst stage, the oocyst. Infections are acquired by the ingestion of infective (sporulated) oocysts in contaminated food or water. Some species of mammalian Isospora have evolved the ability to use paratenic (transport) hosts. In these cases, infections can be acquired by ingestion of an infected paratenic host. Human intestinal isosporiasis is caused by Isospora belli. Symptoms of I. belli infection in immunocompetent patients include diarrhea, steatorrhea, headache, fever, malaise, abdominal pain, vomiting, dehydration, and weight loss, blood is not usually present in the feces. The disease is often chronic, with parasites present in the feces or biopsy specimens for several months to years. Recurrences are common, Symptoms are more severe in AIDS patients, with the diarrhea being more watery. Extraintestinal stages of I. belli have been observed in AIDS patients but not immunocompetent patients. Treatment of I. belli infection with trimethoprim-sulfamethoxazole usually results in a rapid clinical response. Maintenance treatment with trimethoprim-sulfamethoxazole is needed because relapses often occur once treatment is stopped.

Topics: Acquired Immunodeficiency Syndrome; Animals; Anti-Infective Agents; Callithrix; Cats; Coccidiosis; Diarrhea; Disease Reservoirs; Dogs; Feces; Haplorhini; Humans; Immunocompetence; Immunocompromised Host; Intestinal Diseases; Isospora; Mice; Papio; Recurrence; Swine; Trimethoprim, Sulfamethoxazole Drug Combination

Trimethoprim-sulfamethoxazole and metronidazole were used for 14 days to treat 20 children with small intestine bacterial overgrowth (SIBO). SIBO was diagnosed using the lactulose hydrogen breath test. The breath test was repeated 1 month after treatment, and 19 (95.0%) of 20 children showed no evidence of SIBO (P < 0.001). The area under the individual curves showed that children with SIBO exhibited greater hydrogen production before treatment in both the first hour and between 60 and 180 minutes after the breath test. The treatment did not decrease methane production. In conclusion, trimethoprim-sulfamethoxazole and metronidazole was effective in treating children with SIBO.

Topics: Anti-Infective Agents; Area Under Curve; Bacterial Infections; Breath Tests; Child; Humans; Hydrogen; Intestinal Diseases; Intestine, Small; Lactulose; Metronidazole; Poverty; Residence Characteristics; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Abdominal Wall; Actinomyces; Actinomycosis; Adult; Anti-Infective Agents; Humans; Intestinal Diseases; Male; Recurrence; Skin Diseases, Bacterial; Time Factors; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination