Treatment of Dysentery Caused by Antibiotic-Resistant Strains with Triacetyloleandomycin (Taocin)

Abstract

Triacetyloleandomycin (TAO) has proved to be highly effective in treatment of 42 cases of dysentery (15 cases due to antibiotic-sensitive strains and 27 cases due to antibiotic-resistant strains) and 5 cases of carrier.
TAO was given to adults 400 mg at the first time and then 200 mg at intervals of 6 hours for 4 days, 3, 400 mg in total. This is one course of the therapy, reducing the dosis for children according to the age.
Antibiotic-resistant cases consisted of one SM.CM-resistant, 2 SM.TC-resistant and 24 SM. CM. TC-resistant cases, whereas strains isolated from the carriers were all SM. CM. TC-resistant.
As for the effects of therapy in antibiotic-sensitive cases, removal of fever, normalization of stool frequency and normalization of stool chracter were obtained on an average in 1.8, 2.0 and 4.0 days, respectively, and one course of the therapy brought about eradication of dysentery bacilli from stools, no continued or re-discharge of the bacilli was then observed.
In antibiotic-resistant cases, removal of fever, normalization of the number of stool passages and improvement of stool character were attained on an average in 1.6, 2.6 and 3.2 days, respectively. After one course of the therapy, continued discharge of bacilli was observed in 6 cases (22.2%) and re-discharge in 4 cases (14.4%).
In carriers, the discharge of bacilli was stopped during the course of therapy, and no continued discharge was then observed.
It has been not clarified yet how TAO can be so effective in clinical use in spite of a low sensitivity such as 12.5γ/cc100γ/cc in vitro, a problem that requires a further investigation. The fact that dysentery bacilli become more sensitive against antibiotics such as SM, CM, TC with the increase of alkalinity of the culture medium can not explain the clinical effectiveness of TAO, because stools of dysentery patients are usualy rather acid than alkaline.