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. 1973 Apr;48(4):305–312. doi: 10.1136/adc.48.4.305

Comparative efficacy of nalidixic acid and ampicillin for severe shigellosis*

Kenneth C Haltalin, John D Nelson, Helen T Kusmiesz
PMCID: PMC1648332  PMID: 4574641

Abstract

Nalidixic acid is effective in vitro against shigellae including strains multiply-resistant to antibiotics. A comparative study of acute shigellosis in infants and children involved 19 patients treated with ampicillin and 17 treated with nalidixic acid. Stool cultures remained positive longer with nalidixic acid treatment than with ampicillin therapy, and clinical response was slower. The rate of response to therapy was correlated with the serum levels of ampicillin. Though nalidixic acid eliminates shigellae from stools more rapidly than with symptomatic therapy alone, it cannot be recommended for routine treatment of acute shigellosis since it has little effect on the natural course of the illness. In special circumstances when dealing with shigellae that are resistant to ampicillin, tetracycline, and chloramphenicol, nalidixic acid may have a limited use.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. AKBARI A., WARD J. N., HILF M. M., LAVENGOOD R. W., DRAPER J. W. NEGGRAM (NALIDIXIC ACID) IN THE TREATMENT OF URINARY INFECTIONS. J Urol. 1964 Nov;92:552–554. doi: 10.1016/S0022-5347(17)64008-4. [DOI] [PubMed] [Google Scholar]
  2. BARLOW A. M. NALIDIXIC ACID IN INFECTIONS OF URINARY TRACT. LABORATORY AND CLINICAL INVESTIGATIONS. Br Med J. 1963 Nov 23;2(5368):1308–1310. doi: 10.1136/bmj.2.5368.1308. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bauer A. W., Kirby W. M., Sherris J. C., Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 1966 Apr;45(4):493–496. [PubMed] [Google Scholar]
  4. CARROLL G. NEGGRAM (NALIDIXIC ACID): A NEW ANTIMICROBIAL CHEMOTHERAPEUTIC AGENT. J Urol. 1963 Oct;90:476–478. doi: 10.1016/S0022-5347(17)64441-0. [DOI] [PubMed] [Google Scholar]
  5. Davies J. R., Farrant W. N., Uttley A. H. Antibiotic resistance of Shigella sonnei. Lancet. 1970 Dec 5;2(7684):1157–1159. doi: 10.1016/s0140-6736(70)90341-7. [DOI] [PubMed] [Google Scholar]
  6. Farrar W. E., Jr, Eidson M. Antibiotic resistance in Shigella mediated by R factors. J Infect Dis. 1971 May;123(5):477–484. doi: 10.1093/infdis/123.5.477. [DOI] [PubMed] [Google Scholar]
  7. Fernandez L. A. Bacillary dysentery. An institutional outbreak of Shigella sonnei: treatment of 36 cases with nalidixic acid. J Kans Med Soc. 1966 Jul;67(7):359–passim. [PubMed] [Google Scholar]
  8. HALTALIN K. C., NELSON J. D. IN VITRO SUSCEPTIBILITY OF SHIGELLAE TO SODIUM SULFADIAZINE AND TO EIGHT ANTIBIOTICS. JAMA. 1965 Aug 30;193:705–710. doi: 10.1001/jama.1965.03090090011002. [DOI] [PubMed] [Google Scholar]
  9. Haltalin K. C., Kusmiesz H. T., Hinton L. V., Nelson J. D. Treatment of acute diarrhea in outpatients. Double-blind study comparing ampicillin and placebo. Am J Dis Child. 1972 Oct;124(4):554–561. doi: 10.1001/archpedi.1972.02110160092010. [DOI] [PubMed] [Google Scholar]
  10. Haltalin K. C., Nelson J. D. Failure of furazolidone therapy in shigellosis. Am J Dis Child. 1972 Jan;123(1):40–44. doi: 10.1001/archpedi.1972.02110070090011. [DOI] [PubMed] [Google Scholar]
  11. Haltalin K. C., Nelson J. D., Hinton L. V., Kusmiesz H. T., Sladoje M. Comparison of orally absorbable and nonabsorbable antibiotics in shigellosis. A double-blind study with ampicillin and neomycin. J Pediatr. 1968 May;72(5):708–720. doi: 10.1016/s0022-3476(68)80021-6. [DOI] [PubMed] [Google Scholar]
  12. Haltalin K. C., Nelson J. D., Kusmiesz H. T., Hinton L. V. Comparison of intramuscular and oral ampicillin therapy for shigellosis. J Pediatr. 1968 Oct;73(4):617–622. doi: 10.1016/s0022-3476(68)80282-3. [DOI] [PubMed] [Google Scholar]
  13. JAWETZ E. Assay of antibacterial activity in serum. A useful guide for complex antimicrobial therapy. Am J Dis Child. 1962 Jan;103:81–84. doi: 10.1001/archpedi.1962.02080020085014. [DOI] [PubMed] [Google Scholar]
  14. Nelson J. D., Haltalin K. C. In vitro effectiveness of four cephalosporins against Shigellae and clinical ineffectiveness of cephaloglycin. Chemotherapy. 1972;17(1):40–50. doi: 10.1159/000220837. [DOI] [PubMed] [Google Scholar]
  15. Nelson J. D., Haltalin K. C. In-vitro susceptibility of E. coli, Shigellae and Salmonellae to kanamycin and therapeutic implications. Ann N Y Acad Sci. 1966 Jun 14;132(2):1006–1012. doi: 10.1111/j.1749-6632.1966.tb43025.x. [DOI] [PubMed] [Google Scholar]
  16. Nelson J. D., Shelton S., Kusmiesz H. T., Haltalin K. C. Absorption of ampicillin and nalidixic acid by infants and children with acute shigellosis. Clin Pharmacol Ther. 1972 Nov-Dec;13(6):879–886. doi: 10.1002/cpt1972136879. [DOI] [PubMed] [Google Scholar]
  17. Ross S., Controni G., Khan W. Resistance of shigellae to ampicillin and other antibiotics. Its clinical and epidemiological implications. JAMA. 1972 Jul 3;221(1):45–47. [PubMed] [Google Scholar]
  18. Simon H. J., Yin E. J. Microbioassay of antimicrobial agents. Appl Microbiol. 1970 Apr;19(4):573–579. doi: 10.1128/am.19.4.573-579.1970. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. THOMPSON R. E., RAE J. NEGRAM (1-ETHYL-7-METHYL-1,8-NAPHTHYRIDINE-4-ONE-3-CARBOXYLIC ACID): A NEW ANTIBACTERIAL AGENT FOR THE TREATMENT OF URINARY INFECTION. REPORT OF A TRIAL IN GENERAL PRACTICE. Br J Urol. 1964 Mar;36:42–47. doi: 10.1111/j.1464-410x.1964.tb09478.x. [DOI] [PubMed] [Google Scholar]
  20. Yu P. C., Chen H. S. A clinical study of wintomylon in the treatment of shigellosis. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1965 Jul-Sep;6(3):127–131. [PubMed] [Google Scholar]

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