Studies of the Acute Diarrheal Diseases: X C. Further Cultural Observations on the Relative Efficacy of Sulfonamides in Shigella Infections

Abstract

The response of Shigella infections to 10 sulfonamides was campared during the treatment of 1423 cases or carriers. Those under observation were followed by daily fecal cultures. The relative wt. of the infection before and during treatment was detd. by counts of suspicious colorless colonies. 3 consecutive negative cultures were accepted as an indication of bacteriological recovery. However, many of the patients were followed subsequently by repeated cultural tests. Flexner infections responded readily to the sulfonamides. Small doses were adequate. The Schmitz variety responded a little more slowly but Sonne infections were often quite resistant. Considering all infections, 3 sulfonamides[long dash]sulfadiazine, sulfapyrazine and sulfasuxidin[long dash]had superior records. Sulfamerazine and sulfamethazine were a little less effective. Sulfathiazole and sulfaguanidine were the least satisfactory of the 7 drugs that were widely tested. Sulfathaladine, in the series in which it was employed, was less active than sulfasuxidine. Sulfapyridine and sulfanilamide were the least potent. It is concluded that at present sulfadiazine is the drug to be recommended for Shigella infections. Sulfasuxidine is the poorly absorbed compound of choice. Sulfapyrazine, sulfamerazine or sulfamethazine are acceptable but the other sulfaonamides are to be recommended for Shigellosis only when the more effective prepns. are unavailable.