passages: 306
passages: document
passages: Oral ciprofloxacin vs. intramuscular ceftriaxone as empiric treatment of acute invasive diarrhea in children . BACKGROUND Acute invasive diarrhea is a potentially serious condition in children . Because of the increasing resistance of enteric pathogens to commonly used oral antibiotics , intramuscular ceftriaxone has become the routine drug in the treatment of acute invasive diarrhea requiring an emergency visit in southern Israel . The inconvenience of this parenteral regimen created an increased need for oral pediatric formulations for the treatment of invasive diarrhea . OBJECTIVES To evaluate the efficacy and safety of a suspension formulation of ciprofloxacin in the treatment of acute invasive diarrhea in infants and children . PATIENTS AND METHODS From July 1996 through December 1997 , 201 evaluable children ages 6 months to 10 years ( 35 % < 1 year ; 70 % < 3 years ) presenting with acute invasive diarrhea at the Pediatric Emergency Room were randomized to receive either ciprofloxacin suspension ( 10 mg/kg twice a day + im placebo ; n = 95 ) or im ceftriaxone ( 50 mg/kg/day + placebo suspension ; n = 106 ) for 3 days in a double blind manner . Stool cultures for Shigella , Salmonella , Campylobacter spp . and diarrheagenic Escherichia coli were obtained on Days 1 , 3 , 4 to 5 and 21 +/- 5 . Clinical response and safety were assessed on Days 1 , 2 , 3 , 4 to 5 and 21 +/- 5 . RESULTS We isolated 127 pathogens from 121 ( 60 % ) patients : 73 ( 57 % ) Shigella ; 23 ( 18 % ) Salmonella ; 18 ( 14 % ) E. coli ; and 13 ( 10 % ) Campylobacter . Overall bacteriologic eradication on Day 4 to 5 was 99 % for Shigella , 77 % for Salmonella and 77 % for Campylobacter , with no difference between the 2 groups . Clinical cure or improvement was observed in 100 and 99 % of the ciprofloxacin and ceftriaxone groups , respectively . Serum ciprofloxacin values determined on Day 3 of the treatment were higher in the majority of patients than were the MIC50 and MIC90 values for the Shigella and Salmonella spp . isolated . Possible drug-related adverse events occurred in 13 patients [ ciprofloxacin , 8 ( 8 % ) ; ceftriaxone , 5 ( 4.7 % ) ] and were mild and transient . Joint examination was normal during and after completion of therapy in all patients . CONCLUSION Oral ciprofloxacin was as safe and effective as intramuscular ceftriaxone for the empiric treatment of acute invasive diarrhea in ambulatory pediatric patients requiring an emergency room visit .
entities: 307
entities: Intervention_Pharmacological
entities: ciprofloxacin
entities: 308
entities: Intervention_Pharmacological
entities: ceftriaxone
entities: 309
entities: Intervention_Pharmacological
entities: ceftriaxone
entities: 310
entities: Intervention_Pharmacological
entities: ciprofloxacin
entities: 311
entities: Intervention_Pharmacological
entities: ciprofloxacin
entities: 312
entities: Intervention_Pharmacological
entities: ceftriaxone
entities: 313
entities: Intervention_Pharmacological
entities: ciprofloxacin
entities: 314
entities: Intervention_Pharmacological
entities: ceftriaxone
entities: 315
entities: Intervention_Pharmacological
entities: ciprofloxacin
entities: 316
entities: Intervention_Pharmacological
entities: ciprofloxacin
entities: 317
entities: Intervention_Pharmacological
entities: ceftriaxone
entities: 318
entities: Intervention_Pharmacological
entities: ciprofloxacin
entities: 319
entities: Intervention_Pharmacological
entities: ceftriaxone
entities: 320
entities: Outcome_Other
entities: efficacy
entities: 321
entities: Outcome_Other
entities: safety
entities: 322
entities: Outcome_Physical
entities: Stool cultures for Shigella , Salmonella , Campylobacter spp . and diarrheagenic Escherichia coli
entities: 323
entities: Outcome_Physical
entities: Clinical response and
entities: 324
entities: Outcome_Other
entities: safety
entities: 325
entities: Outcome_Physical
entities: Clinical cure or improvement
entities: 326
entities: Outcome_Adverse-effects
entities: adverse events
entities: 327
entities: Outcome_Physical
entities: Joint examination
entities: 328
entities: Outcome_Other
entities: safe
entities: 329
entities: Outcome_Other
entities: effective
entities: 330
entities: Participant_Condition
entities: acute invasive diarrhea
entities: 331
entities: Participant_Age
entities: children
entities: 332
entities: Participant_Age
entities: children .
entities: 333
entities: Participant_Condition
entities: acute invasive diarrhea
entities: 334
entities: Participant_Age
entities: infants and children
entities: 335
entities: Participant_Sample-size
entities: 201
entities: 336
entities: Participant_Age
entities: children ages 6 months to 10 years ( 35 % < 1 year ; 70 % < 3 years )
entities: 337
entities: Participant_Condition
entities: presenting with acute invasive diarrhea at the Pediatric Emergency Room
entities: 338
entities: Participant_Condition
entities: ambulatory pediatric patients requiring an emergency room visit .