A randomized double-blind clinical trial of the effect of non-absorbable oral polymyxin on infants with severe infectious diarrhea

A randomized double-blind clinical trial of the effect of non-absorbable oral polymyxin on infants with severe infectious diarrhea

Autor Tahan, Soraia Autor UNIFESP Google Scholar
Morais, Mauro Batista de Autor UNIFESP Google Scholar
Wehba, Jamal Autor UNIFESP Google Scholar
Scaletsky, Isabel Cristina Affonso Autor UNIFESP Google Scholar
Machado, Antonia Maria de Oliveira Autor UNIFESP Google Scholar
Silva, Licia de Queiroz Campos Deveza e Autor UNIFESP Google Scholar
Fagundes Neto, Ulisses Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo The present study evaluated the effect of non-absorbable oral polymyxin on the duodenal microflora and clinical outcome of infants with severe infectious diarrhea. Polymyxin was chosen because classic enteropathogenic Escherichia coli was more sensitive to this antibiotic. Twenty-five infants were randomly assigned to a 7-day treatment with oral polymyxin (2.5 mg/kg in 4 daily doses) or placebo. Duodenal and stool cultures were performed before and after the treatment. Five patients were excluded during the study because of introduction of parental antibiotic therapy due to clinical sepsis (N = 3) or rapid clinical improvement (N = 2). In the polymyxin group, small bowel bacterial overgrowth occurred in 61.5% of the cases (8/13) before treatment and in 76.9% (10/13) after treatment. In the placebo group these values were 71.4% (5/7) and 57.1% (4/7), respectively. By the 7th day, clinical cure was observed in 84.6% of the cases (11/13) in the polymyxin group and in 71.4% (5/7) in the placebo group (P = 0.587). Considering all 25 patients included in the study, clinical cure occurred on the 7th day in 12/14 cases (85.7%) in the polymyxin group and 6/11 cases (54.5%) in the placebo group (P = 0.102). Clinical sepsis occurred in 3/11 (27.3%) of the patients in the placebo group and in none (0/14) in the polymyxin group (P = 0.071). Oral polymyxin was not effective in reducing bacterial overgrowth or in improving the clinical outcome of infants hospitalized with severe infectious diarrhea. Taking into account the small sample size, the rate of cure on the 7th day and the rate of clinical sepsis, further studies with greater number of patients are necessary to evaluate these questions.
Palavra-chave Infants
Infectious diarrhea
Duodenal microflora
Polymyxin
Sepsis
Idioma Inglês
Data de publicação 2007-02-01
Publicado em Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 40, n. 2, p. 209-219, 2007.
ISSN 0100-879X (Sherpa/Romeo, fator de impacto)
Publicador Associação Brasileira de Divulgação Científica
Extensão 209-219
Fonte http://dx.doi.org/10.1590/S0100-879X2006005000064
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000243977400007
SciELO S0100-879X2007000200007 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/3548

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