The Influence of Chloramphenicol on Dysentery Bacilli and their Drug Resistance
1958 Volume 32 Issue 2 Pages 39-61
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1958 Volume 32 Issue 2 Pages 39-61
By the universal use of antibiotics in recent years, the treatment of bacillary dysentery has made great progress, but at the same time, the problem of resistance of he dysentery bacilli has come to assume an important aspect in the treatment of this disease.
The author made a study of the bacilli excretion of 868 cases of ysentery for the purpose of elucidating the behavior of such antibiotics, and a series of measuremens of the bacillar sensitivity against chloramphenicol (CM) in the acilli sampled form 196 CM-treated patients in every stage of the entire course of the disease, for the purpose of following up the change in the resistance of the acilli. The results obtained were as follows:
1. In 775 cases of dyentery and 93 cases of Ekiri (Severe dysentery form of children with a sudden onse) the rate of bacilli detection was found to be high at the earliest stage, rising to 40-48%, but to fall off with progress of the disease. The persistence of bacilli excretion is longer n the early stage of the disease, but shortens afterwards. When the patient recovered to excrete normal feces, the rate of bacilli detection was 16.2%.
2. The xtinction rate of bacilli following CM administration was 62 and 80, respectively within 24 and 48 hours.
3. Reappearance of bacilli following application of CM ccurred in 19.4% of the cases, and clinical relapse for once only in 22.6%, for twice in 2.8% and for three times in 0.4% of the cases.
4. By use of CM, most of the cases showed marked improvements in their complaints and the nature of their feces, and the frequency of defecation also decreased, even a tendency to onstipation being observed in many cases.
5. In the dysentery bacilli isolated from 196 patients on different days during the entire course of disease the CM γy/cc value showed the same level throughout in 29%, but fell gradually lower in 51%, the sum of the two above amounting to 80%. In 9.2% it rose from the initial stage to the middle and rose in 10.8% steadily up to the final end of the disease.
6. In the greatest majority of the isolated bacilli the CM γ/cc value remained within the range of 0.39-3.13 and in some cases reached the maximum of 25 γ/cc, but fell lower during the course of the disease.
7. The CM gamma;/cc value was not always found correlated with the extinction of bacilli, no delay in extinction being confirmed even with highly resitant bacilli.
8. Most of he bacilli excreted by the patients after CM also showed lowered CM γ/cc values with the lapse of time, so no data indicating lower sensitivity of CM-treated ases were obtained, compared with that of not CM-treated cases.
9. No dysentery bacilli with high resistance against CM could be found.
