Bicozamycin, A Poorly Absorbable Antibiotic, Effectively Treats Travelers' Diarrhea

Abstract

The efficacy of bicozamycin, a poorly absorbable antibiotic, in the treatment of acute diarrhea was assessed in a prospective, double-blind study of 140 adults from the USA visiting Guadalajara, Mexico. Patients randomly received bicozamycin (500 mg orally 4 times daily) or placebo for 3 days. The mean duration of illness was shorter in the bicozamycin than the placebo treatment groups for patients with diarrhea due to Shigella (37 vs. 90 h; P = 0.01), toxigenic Escherichia coli (31 vs. 60 h; P = 0.003) and unknown pathogens (18 vs. 41 h; P = 0.02). Cramps were significantly relieved by bicozamycin in all patients. Treatment failed in significantly fewer patients treated with bicozamycin than those treated with placebo when diarrhea was associated with Shigella, Salmonella or toxigenic E. coli. Bicozamycin was well tolerated and appears to be effective therapy for acute travelers'' diarrhea of diverse causes. These data show the value of an antibiotic in the therapy of toxigenic E. coli infection and indicate a need to reevaluate the clinical dictum that nonabsorbable antibiotics are ineffective against invasive enteropathogens.