The efficacy of trimethoprim-sulfamethoxazole treatment in children with acute bloody diarrhea
Keywords:
acute bloody diarrhea, trimethoprim- sulfamethoxazole, fecal analysis, bloody stool
Abstract
Background The etiologies of bloody diarrhea are shigella,amoeba, enterocolitis, trichuriasis, and other causes i.e, EIEC,
Campylobacter jejuni or rotavirus. In developing countries,
trimetroprim-sulfamethoxazole (TMP-SMP) is effective in 80%
of children with bloody diarrhea.
Objective To determine the efficacy of trimethoprim-sulfa-
methoxazole (TMP-SMX) treatment in children with acute bloody
diarrhea.
Methods A randomized double blind clinical trial was conducted
in Adam Malik Hospital and Dr. Pirngadi Hospital Medan during
September 2003-March 2004. Children aged 2-24 months old
with diagnosis of acute bloody diarrhea were randomized into two
groups to either receive TMP-SMX or placebo for 5 days.
Microscopic fecal analysis was performed on the first, second,
fifth and twelfth day, and the results were compared.
Results A total of 68 children consisted of 48 (71%) boys and 20
(29%) girls were enrolled. Each group had 34 participants.
Analysis of the first day showed leukocyte and erythrocyte in the
stool specimens, which were all absent on the twelfth day in both
groups. There was no difference in stool analysis between TMP-
SMX and placebo group in day two (P=0.758), day five (P=0.341)
and day twelve. Diarrhea duration in TMP-SMX and placebo
group was 7.18 days and 6.65 days, respectively. This different
was statistically not significant (P=0.385).
Conclusion There is no difference in the efficacy of trimethoprim-
sulfamethoxazole treatment compared to placebo in children with
acute bloody diarrhea.
References
1. Larry K, Pickering, Snyder JD. Gastroenteritis. In: Behrman
RE, Kliegman RM, Jenson HB, editors. Nelson textbook of
pediatrics. 16th edition. Philadelpia: WB. Saunders; 2000.
p. 765–8.
2. Noerasid H, Suraatmadja S, Asnil PO. Gastroenteritis (Diare)
Akut. In: Suharyono, Boediarso A, Halimun EM, editors.
Gastroenterologi Anak Praktis. Edisi ke 2. Jakarta: Balai
Penerbit Fakultas Kedokteran Universitas Indonesia; 1994. p.
51–76.
3. In Strickland GT. Hunter’s tropical medicine and emerging
infectious diseases. 8th edition. Philadelphia: WB Saunders
Company; 2000. p. 130-3.
4. Ditjen PPM & PPL Departemen Kesehatan RI. Buku ajar
diare. Pendidikan Medik Pemberantasan Diare. Jakarta; 1999.
5. The outpatient management of bloody diarrhea in young
children. University of Zambia Medical Library. available
from: url: http://www.meguiide.org.zm/who.docs/diarrh.htm.
6. Ditjen PPM & PPL Departemen Kesehatan RI. Tata laksana
kasus diare bermasalah. Badan Koordinasi Gastroenterologi
Anak Indonesia. Jakarta; 1999.
7. Diarrheal disease. available from: url: http://www. courseweb.
edteched.outtawa.ca /medicineHealth/Interventions/
Diarrhea-e.htm.
8. The John Hopkins and IFRC Public Health Guide for
Emergencies. available from: url : http://www.ifrc.org/docs/
pubs/health/chapter .
9. Mathan. Diarrheal disease. Departement of Gastrointestinal
Sciences, Christian Medical College and Hospital, Vellore,
India. available from: url: http://www.rsm.ac.uk/pub/
mathan.pdf.
10. Soeparto P, Djupri LS, Sudarmo SM, Ranuh RG. Sindrom diare.
Edisi ke2. Surabaya: Gramik FK Universitas Airlangga; 1999.
11. Gondwe R, Pruyn N, Torres G, Varma R. Diarrheal disease:
prevention and management. available from: url: http://
arcz.bumc.bu.edu/IH887/presentation.
12. The outpatient management of bloody diarrhea in young
children. available from: url: http://www.who.int/child-
adolescent-health/New-Publication/CHIL-HEALTH.
13. The management of bloody diarrhea in young children. WHO/
CDD/94.49. available from: url: http://www.who.int/child-
adolescent-health/New-Publication/CHILD-HEALTH.
14. Edmundson SA, Edmundson WC. Diarrhea in India and
Indonesia. available from URL: http://www.midcoast.com.au/
edmundsons/c8.
15. World Health Organization. Guideline for the control of
epidemic due to shigella dysentriae 1. Geneve: WHO; 1995.
Publication no. WHO/CDR/95.4.
16. Lexomboon U, Mansuwan P, Duangmani C, Benjadol P, McMinn
MT. Clinical evaluation of co-trimoxazole and furazolidone in
treatment of shigellosis in children. BMJ 1972;1:23-6.
17. Gandasoebrata R. Penuntun laboratorium klinik. Jakarta:
Dian Rakyat; 1989. p. 180-5.
18. Soenarto Y, Suryono A, Supardi S. Dysentry in children under
five year of age: A longitudinal prospective study in primary
health care in Indonesia. Paediatr Indones 2001;41:141-8.
19. Ditjen PPM & PPL, Departemen Kesehatan RI. Tata laksana
kasus diare bermasalah. Badan Koordinasi Gastroenterologi
Anak Indonesia. Jakarta; 1999.
20. Soenarto Y, Sebodo T, Suryantoro P, Krisnomurti, Haksohusodo
S, Ilyas, et al. Bacteria, parasitic agents and rotaviruses
associated with acute diarrhea in hospital in-patient Indonesia
children. Trans Roy Soc Trop Med Hyg 1983;77:729-30.
21. Boediarso A. Spektrum bakteri dan uji sensitivitas pada disentri.
Majalah Kesehatan Masyarakat Indonesia 1993; 21(6).
22. Suharleni. Sebaran mikroba pada disentri di Bagian Ilmu
Kesehatan Anak FKUI/RSCM [Thesis]. Jakarta: Universitas
Indonesia; 1992.
23. Dwipoerwantoro PG, Pulungsih SP, Susanti NJ, Sadikin H.
Resistensi antibiotik terhadap shigella. Presented in Kongres
Nasional II BKGAI, Bandung, 3-5 Juli 2003.
24. Guerrero L, Calva JJ, Morrow AL, Velazquez FR, Tuz-Dzib F,
Lopez-Vidal Y, et al. Asymptomatic Shigella infection in a
cohort of Mexican children younger than two years of age.
Pediatr Infect Dis J 1994;13:597-602.
25. Triatmojo P, Simanjuntak CH. Distribusi geografis pola
resistensi shigella terhadap ampicillin dan beberapa jenis
antibiotik pilihan untuk daerah Jakarta dan Jawa Barat. MKMI
1993; 21(2).
RE, Kliegman RM, Jenson HB, editors. Nelson textbook of
pediatrics. 16th edition. Philadelpia: WB. Saunders; 2000.
p. 765–8.
2. Noerasid H, Suraatmadja S, Asnil PO. Gastroenteritis (Diare)
Akut. In: Suharyono, Boediarso A, Halimun EM, editors.
Gastroenterologi Anak Praktis. Edisi ke 2. Jakarta: Balai
Penerbit Fakultas Kedokteran Universitas Indonesia; 1994. p.
51–76.
3. In Strickland GT. Hunter’s tropical medicine and emerging
infectious diseases. 8th edition. Philadelphia: WB Saunders
Company; 2000. p. 130-3.
4. Ditjen PPM & PPL Departemen Kesehatan RI. Buku ajar
diare. Pendidikan Medik Pemberantasan Diare. Jakarta; 1999.
5. The outpatient management of bloody diarrhea in young
children. University of Zambia Medical Library. available
from: url: http://www.meguiide.org.zm/who.docs/diarrh.htm.
6. Ditjen PPM & PPL Departemen Kesehatan RI. Tata laksana
kasus diare bermasalah. Badan Koordinasi Gastroenterologi
Anak Indonesia. Jakarta; 1999.
7. Diarrheal disease. available from: url: http://www. courseweb.
edteched.outtawa.ca /medicineHealth/Interventions/
Diarrhea-e.htm.
8. The John Hopkins and IFRC Public Health Guide for
Emergencies. available from: url : http://www.ifrc.org/docs/
pubs/health/chapter .
9. Mathan. Diarrheal disease. Departement of Gastrointestinal
Sciences, Christian Medical College and Hospital, Vellore,
India. available from: url: http://www.rsm.ac.uk/pub/
mathan.pdf.
10. Soeparto P, Djupri LS, Sudarmo SM, Ranuh RG. Sindrom diare.
Edisi ke2. Surabaya: Gramik FK Universitas Airlangga; 1999.
11. Gondwe R, Pruyn N, Torres G, Varma R. Diarrheal disease:
prevention and management. available from: url: http://
arcz.bumc.bu.edu/IH887/presentation.
12. The outpatient management of bloody diarrhea in young
children. available from: url: http://www.who.int/child-
adolescent-health/New-Publication/CHIL-HEALTH.
13. The management of bloody diarrhea in young children. WHO/
CDD/94.49. available from: url: http://www.who.int/child-
adolescent-health/New-Publication/CHILD-HEALTH.
14. Edmundson SA, Edmundson WC. Diarrhea in India and
Indonesia. available from URL: http://www.midcoast.com.au/
edmundsons/c8.
15. World Health Organization. Guideline for the control of
epidemic due to shigella dysentriae 1. Geneve: WHO; 1995.
Publication no. WHO/CDR/95.4.
16. Lexomboon U, Mansuwan P, Duangmani C, Benjadol P, McMinn
MT. Clinical evaluation of co-trimoxazole and furazolidone in
treatment of shigellosis in children. BMJ 1972;1:23-6.
17. Gandasoebrata R. Penuntun laboratorium klinik. Jakarta:
Dian Rakyat; 1989. p. 180-5.
18. Soenarto Y, Suryono A, Supardi S. Dysentry in children under
five year of age: A longitudinal prospective study in primary
health care in Indonesia. Paediatr Indones 2001;41:141-8.
19. Ditjen PPM & PPL, Departemen Kesehatan RI. Tata laksana
kasus diare bermasalah. Badan Koordinasi Gastroenterologi
Anak Indonesia. Jakarta; 1999.
20. Soenarto Y, Sebodo T, Suryantoro P, Krisnomurti, Haksohusodo
S, Ilyas, et al. Bacteria, parasitic agents and rotaviruses
associated with acute diarrhea in hospital in-patient Indonesia
children. Trans Roy Soc Trop Med Hyg 1983;77:729-30.
21. Boediarso A. Spektrum bakteri dan uji sensitivitas pada disentri.
Majalah Kesehatan Masyarakat Indonesia 1993; 21(6).
22. Suharleni. Sebaran mikroba pada disentri di Bagian Ilmu
Kesehatan Anak FKUI/RSCM [Thesis]. Jakarta: Universitas
Indonesia; 1992.
23. Dwipoerwantoro PG, Pulungsih SP, Susanti NJ, Sadikin H.
Resistensi antibiotik terhadap shigella. Presented in Kongres
Nasional II BKGAI, Bandung, 3-5 Juli 2003.
24. Guerrero L, Calva JJ, Morrow AL, Velazquez FR, Tuz-Dzib F,
Lopez-Vidal Y, et al. Asymptomatic Shigella infection in a
cohort of Mexican children younger than two years of age.
Pediatr Infect Dis J 1994;13:597-602.
25. Triatmojo P, Simanjuntak CH. Distribusi geografis pola
resistensi shigella terhadap ampicillin dan beberapa jenis
antibiotik pilihan untuk daerah Jakarta dan Jawa Barat. MKMI
1993; 21(2).
Published
2007-02-28
How to Cite
1.
Nafianti S, Ramayani O, Daulay D, Supriatmo S, Hasibuan B, Sinuhaji A. The efficacy of trimethoprim-sulfamethoxazole treatment in children with acute bloody diarrhea. PI [Internet]. 28Feb.2007 [cited 22Nov.2024];47(1):17-0. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/336
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Received 2016-08-25
Accepted 2016-08-25
Published 2007-02-28
Accepted 2016-08-25
Published 2007-02-28
