A comparative study of the efficacy and tolerability of parenteral ceftriaxone and cefotaxime in pediatric population for acute bacillary dysentery in a tertiary care hospital

Background: Diarrheal disorders in childhood account for a large proportion (18%) of childhood mortality. Among diarrheal diseases, dysentery is a major cause of childhood morbidity and mortality, especially in developing countries.Methods: This is an open labelled, prospective, randomised, comparative study carried out at Dr. B. R. Ambedkar Medical College Hospital, Bangalore from November 2014 to November 2015 after Institutional Ethics Committee approval. A total of 80 Paediatric patients who met the inclusion criteria were included in the study after taking written informed consent from parents and assigned into two groups, Group A- Inj. Ceftriaxone (50-100mg/kg/day) and Group B- Inj. Cefotaxime (100 mg/kg/day) in divided doses for a period of 3-5 days based on requirement.Results: In this study, Cefotaxime was non inferior to Ceftriaxone as the Mean Duration of Hospitalisation was 3.30±0.72 days in Group A and 3.30± 0.72 days in Group B with p value of 1.000, showing no statistically significant difference. Both were well tolerated without any reports of ADR (Adverse Drug Reaction).Conclusions: In this study shows that Inj. Cefotaxime is equally efficacious and well tolerated as Inj. Ceftriaxone in the treatment of Acute Bacillary Dysentery in paediatric patients.

TREATMENT OF CHRONIC SHIGELLA INFECTION IN CHILDREN WITH ORAL POLYMYXINS

Many chemotherapeutic agents can alleviate the symptoms of acute bacillary dysentery and suppress the causative organisms. In chronic Shigella infection, however, most agents have only limited usefulness. In an institution for mentally defective children 93% of 116 fresh cases of shigellosis responded to conventional chemotherapeutic measures, but only 63% of 78 chronic cases. Polymyxin B and E are highly bactericidal for Shigella organisms in vitro. These drugs are stable and are not significantly absorbed from the intestinal tract when taken by mouth. Twenty-three children with chronic intestinal infections due to Shigella paradysenteriae (Flexner) were given daily oral doses of 15 to 20 mg./kg. polymyxin for 10 days. Twenty (87%) were unequivocally cured of their infection which had previously resisted therapy with sulfonamides and other antimicrobial agents. No toxic side-effects were observed. Polymyxin appears to be a useful drug for the oral treatment of chronic Shigella infection.