How to cope with increasing number of resistant strains of bacterial dysentery hasnow become our primary concern.
On the other hand, macrolide antibiotics such as erythromycin estrate without in vitro antibiotic activity against shigella has been known to be effective for the treatment of bacillary dysentery.
Clinical trial with acetyl-spiramycin, a new macrolides, was then carried out.
Materials and Methodes: Seven patients with bacillary dysentery and 23 carriers were treated with acetylspiramycin. Daily dose of 800 mg (200 mg every 6 hours) of thantimicrobials was administrated for 5 days (totaling 4000 mg).
Results: Rapid improvement of fever and diarrhea were seen.
Considering the high tendency of natural healing, these results were not always tobe attributed to the effect of acetyl-spiramycin alone.
Culture of shigella from stool remained no longer positive after the fifth day ofadministration of the medicine.
The bacilli disappeared within 2 days after treatment in 23 cases (76.6%), and within 5 days in 3 (23.3%), mean being 2.4 days. Neither continuous positive culture, nor reappearance of the bacilli was noted in this series.
Any remarkable side effects did not occure in our trial.
No strains of Shigella from the 30 patients were sensitive to acetyl-spiramycin invitro. Previously, clinical trial with novobiocin, a non-macrolide antibiotics, on the treatment of dysentery was carried out without appreciable results. This is highly indicative of different clinical effects between the macrolides, such as actyl-spiramycin and erythromycin estrate, and the non-macrolides, such as novobiocin, even if they are similar in antibiotic spectrum.
