Short-Course Norfloxacin and Trimethoprim-Sulfamethoxazole Treatment of Shigellosis and Salmonellosis in Egypt

Samir BassilyU.S. Naval Medical Research Unit No. 3, Infectious Disease Department and Enterics Division, U.S. Naval Medical Research Institute, Abbassia Fever Hospital, Egyptian Ministry of Health, Cairo, Egypt

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Kenneth C. HyamsU.S. Naval Medical Research Unit No. 3, Infectious Disease Department and Enterics Division, U.S. Naval Medical Research Institute, Abbassia Fever Hospital, Egyptian Ministry of Health, Cairo, Egypt

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Nabil A. El-MasryU.S. Naval Medical Research Unit No. 3, Infectious Disease Department and Enterics Division, U.S. Naval Medical Research Institute, Abbassia Fever Hospital, Egyptian Ministry of Health, Cairo, Egypt

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Zoheir FaridU.S. Naval Medical Research Unit No. 3, Infectious Disease Department and Enterics Division, U.S. Naval Medical Research Institute, Abbassia Fever Hospital, Egyptian Ministry of Health, Cairo, Egypt

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Eleanor CrossU.S. Naval Medical Research Unit No. 3, Infectious Disease Department and Enterics Division, U.S. Naval Medical Research Institute, Abbassia Fever Hospital, Egyptian Ministry of Health, Cairo, Egypt

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August L. BourgeoisU.S. Naval Medical Research Unit No. 3, Infectious Disease Department and Enterics Division, U.S. Naval Medical Research Institute, Abbassia Fever Hospital, Egyptian Ministry of Health, Cairo, Egypt

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Ezzat AyadU.S. Naval Medical Research Unit No. 3, Infectious Disease Department and Enterics Division, U.S. Naval Medical Research Institute, Abbassia Fever Hospital, Egyptian Ministry of Health, Cairo, Egypt

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Richard G. HibbsU.S. Naval Medical Research Unit No. 3, Infectious Disease Department and Enterics Division, U.S. Naval Medical Research Institute, Abbassia Fever Hospital, Egyptian Ministry of Health, Cairo, Egypt

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In a double-blind clinical study, 109 adult Egyptian patients infected with Shigella spp. and 45 infected with Salmonella spp. were randomly assigned to three treatment groups: 1) norfloxacin in a single 800-mg dose, 2) norfloxacin, 400 mg twice a day for three days, and 3) trimethoprim (160 mg)-sulfamethoxazole (800 mg) (TMP-SMX), twice a day for three days. Among Shigella-infected patients, diarrheal symptoms had resolved in 86–97% and bacteriologic failure (repeat positive stool culture) occurred in only two patients five days after the start of the three treatment regimens. Among Salmonella-infected patients, diarrheal symptoms had resolved in 76–82% of patients and bacteriologic failure was common (18–36%) five days after the start of therapy. These data indicate that short-course therapy with either norfloxacin or TMP-SMX can be effectively used to treat shigellosis in adults in developing countries. However, for uncomplicated Salmonella spp. infection, short-course therapy with norfloxacin and TMP-SMX may not lead to a rapid resolution of symptoms or consistently eliminate this enteropathogen.

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