Nalidixic Acid Therapy in Bacillary Dysentery with Particular Reference to Combined Therapy with Other Drugs
1967 Volume 41 Issue 7 Pages 256-267
Details
1967 Volume 41 Issue 7 Pages 256-267
Twenty nine patients and 27 carriers in 1965, 22 patients and 29 carriers in 1966, totaling 107 in number, of bacillary dysentery were treated with nalidixic acid (NA). Some of them were treated with NA alone with unsatisfactory results. Then, others were tried with combinations of NA and other antibiotics, such as kanamycin (KM), methane-sulfonate colistin (CoM), taocin (TO), and erythromycin (EM).
The clinical data and some relevant laboratory data are summed up as follows:
1) Redischarge of causative bacilli was seen in 8 (33.3%) out of 24 persons with single use of NA. In one case out of the 8, the bacilli was proved to have had spontaneous NA-resistance before the treatment. Strains from 3 persons developed acquired-resistance to 400 mcg/ml NA concentration in the course of the treatment. There appeared little difference in clinical effects between 3 gr and 4 gr dailydose of NA within a 7 days-administration-period. These results should be looked upon as rather unfavorable.
2) Tried in combination with NA are CoM, KM, TO, and EM. NA and CoM in combined use are applied to 64 cases; bacillary redischarge occurred in 2 (3.1%), both of which were carriers. NA and KM were applied to 8 cases; bacillary redischarge occurred in one case who was also a carrier. Redischarged bacilli obtained from these three cases showed NA-sensitivity in-vitro. NA and TO, NA and EM were tried on 8 cases and 3 cases respectively; in none of them bacilli redischarge occurred. These results are considered to be almost satisfactory in the light of therapeutical criteria accepted in the antibiotic field at the present time.
3) No particularly mentionable side effects concerning NA therapy, single or combined, were encountered so far.
4) Sensitivity of NA-sensitive causative bacilli ranged from 3.12 to 6.25 mcg/ml NA concentration level in-vitro, regardless of whether they were sensitive or resistant to other usual antibiotics such as streptomycin, chloramphenicol, and tetracycline. No cross-resistance was seen between NA and above mentioned antibiotics.
5) In in-vitro experiments, no antagonism was proved between NA and CoM, KM, Oleandmycin or EM. In some cases, they were independent with each other, and in others, they were proved to be synergic in their anti-microbial activities.
