Médecine tropicale : revue du Corps de santé colonial
Volume 54, Issue 4, 1994, Pages 319-323

Short-term ciprofloxacin treatment of bacillary dysentery due to Shigella dysenteriae type 1 in Rwandan refugees [Traitement court par la ciprofloxacine de la dysenterie bacillaire à Shigella dysenteriae type 1 chez des réfugiés Ruandais.] (Article)

Soares J.L.* , Arendt V. , Coue J.C. , Milleliri J.M. , Philips B. , Regis R. , Mérouze F. , Rey J.L.
  • a Service de Médecine des Collectivités, I.M.T.S.S.A., Marseille-Armées, France
  • b Service de Médecine des Collectivités, I.M.T.S.S.A., Marseille-Armées, France
  • c Service de Médecine des Collectivités, I.M.T.S.S.A., Marseille-Armées, France
  • d Service de Médecine des Collectivités, I.M.T.S.S.A., Marseille-Armées, France
  • e Service de Médecine des Collectivités, I.M.T.S.S.A., Marseille-Armées, France
  • f Service de Médecine des Collectivités, I.M.T.S.S.A., Marseille-Armées, France
  • g Service de Médecine des Collectivités, I.M.T.S.S.A., Marseille-Armées, France
  • h Service de Médecine des Collectivités, I.M.T.S.S.A., Marseille-Armées, France

Abstract

In 1994, an outbreak of dysentery caused by Shigella dysenteriae type I resistant to all public health antibiotics in vitro occurred among rwandan refugees in Zaïre. The only active antimicrobial agent available was ciprofloxacin. It was administered to hospitalized patients in a conventional 5-day schedule. To ration the supply for the benefit of the greatest number, a randomized blinded study was performed to compare the effectiveness of short-term treatment (1 g of ciprofloxacin in a single daily doses for 2 days) with that of the standard treatment (1 g of ciprofloxacin in two daily doses for 5 days). The study included 57 refugees over the age of 15 years with dysentery. Shigella dysenteriae type I was identified in 26 patients. Except for sex distribution, there was no significant difference in clinical and bacteriologic features of the two populations. Treatment failed in 12 cases, i.e., 7 of 29 patients who received the short-term treatment and 5 of 28 patients who received the standard treatment. Efficacy of ciprofloxacin was not dependent on the mode of treatment, taking into account clinical or bacteriologic criteria. These results indicated that the duration of ciprofloxacin treatment for dysentery caused by Shigella dysenteriae type 1 could be shortened to two days. Short-term treatment has several advantages. One is cost-effectiveness since fluoroquinolones are costly and scarce. Another is to allow treatment of a greater number of patients by improving compliance.

Author Keywords

[No Keywords available]

Index Keywords

refugee controlled clinical trial Cost benefit analysis shigella dysenteriae economics ciprofloxacin clinical trial Rwanda dose response double blind procedure human Refugees controlled study randomized controlled trial Dose-Response Relationship, Drug Drug Administration Schedule drug administration Humans Dysentery, Bacillary male female Double-Blind Method isolation and purification Article adult Feces microbiology cost-benefit analysis shigellosis
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0009486480&partnerID=40&md5=293e2394825c41b705e369b0f0c02a98
ISSN: 0025682X
Cited by: 6
Original Language: French