Oral or Intravenous Trimethoprim-Sulfamethoxazole Therapy for Shigellosis

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Abstract
A review of the literature concerning shigellosis treated with trimethoprim-sulfamethoxazole (TMP-SMZ) revealed comparative studies of 149 cases and noncomparative studies of 147 cases. Bacteriologic and clinical success rates were ⩾90% and TMP-SMZ compared favorably with alternative drug therapy. In the present study TMP-SMZ was given intravenously as initial therapy to 11 children hospitalized for severe shigella colitis. Bacteriologic and clinical responses were comparable to those observed with oral TMP-SMZ therapy. Pharmacokinetic studies revealed substantial differences between the responses of these children and those reported for adult patients; a higher ratio of SMZ to TMP (50:1) was found in children. It is concluded that TMP-SMZ is effective therapy for shigellosis and is the drug of choice in areas where ampicillin resistance is prevalent.