A comparison of furazolidone and ampicillin in the treatment of invasive diarrhea

Abstract

A single-blind, parallel, randomized study comparing the efficacy of furazolidone and ampicillin in the treatment of children with acute invasive diarrhea was conducted among outpatients at the Hospital General de Ciudad Nezahualcoyotl in Mexico between August 1986 and October 1987. Seventy-eight patients were admitted to the study; 39 were randomized to receive furazolidone (5 mg/kg/day for 5 days), and 39 were randomized to receive ampicillin (100 mg/kg/day for 5 days). The enteropathogens Shigella sp, Salmonella sp, and Escherichia coli were isolated in 87.2% of the initial stool cultures. A preliminary assessment of the patients' clinical status was made on day 3. At that time 97.4% of furazolidone patients had improved, compared with 65.7% of patients in the ampicillin group (p = 0.002). At the end of the treatment period (day 6), 100% of evaluable patients treated with furazolidone had a negative stool culture, compared with 71% of evaluable patients treated with ampicillin (p = 0.002). Both absence of watery stools by day 5 and a negative day 6 stool culture determined treatment success. Overall, there was a greater percentage of treatment successes in the furazolidone group than in the ampicillin group (92.3% versus 51.3%, p = 0.001). Tolerance to both drugs was very good. One patient treated with ampicillin developed urticaria, which required discontinuation of treatment; the reaction resolved spontaneously after treatment discontinuation. No adverse reactions were reported in the furazolidone group. The results of this study showed that furazolidone was more effective than ampicillin in the treatment of acute invasive diarrhea. It is suggested that furazolidone should be the treatment of choice for this disease.