ACUTE CHILDHOOD DIARRHEA: A REVIEW OF RECENT ADVANCES IN THE STANDARD MANAGEMENT
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Seema Alam, Rajeev Khanna, Uzma Firdaus
Pediatric Gastroenterology Section, Department of Pediatrics, JNMC, AMU, Aligarh.
Corresponding Author: Dr Seema Alam, Reader, Department of Pediatrics, JN Medical College, AMU, Aligarh, UP. Email: email@example.com
1. Antimicrobials and Antisecretory drugs
Bacillary dysentery or Shigellosis: Various studies on shigellosis done recently are available in the tabulated form (Table 8). High rates of resistance to various antibiotics are present, hence one of the fluoroquinolones ciprofloxacin/ (norfloxacin/ofloxacin) should be the first line of treatment for Shigellosis. If there is no improvement (disappearance of blood), on the fluoroquinolone, within 48 hours then depending upon the general condition the patient should be shifted to a oral (cefixime) or intravenous (ceftriaxone) cephalosporin. Drug dosage and schedule should be as mentioned in table 9. Based on its efficacy, safety and reduced cost, ciprofloxacin has been recommended by WHO as the first line antibiotic for shigellosis 76.
Table 8: Percentage resistance to antimicrobials in the shigella isolates (2001-2005) from the Indian subcontinent.
Co=Cotrimoxazole, NA=Nalidixic acid, Cx&/Nx=Ciprofloxacin&/Norfloxacin, Cef=Cefixime/Ceftriaxone
MDR= Multidrug resistance
* Median percentage resistance to the antimicrobials
** Median percentage Multidrug resistance.
Table 9: Drugs dosage and schedules for the antibiotics against Shigellosis.
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