The effect of sulfathiazole in the treatment of dysentery in children

Abstract

N INVESTIGATION of the effectiveness of sulfathiazole in the treatment of infectious diarrhea was begun in the Children's Division of the Cook County Hospital during the summer months of 1940. Forty-six cases were included in the study. In the preceding summer sulfanilamide was used for the treatment of similar cases but yielded unsatisfactory results. Reports of other observers who used sulfanilamide for this disease are inconclusive. With the introduction of sulfathiazo]e, a number of workers began investigating the value of this chemotherapeutic agent in the treatment of diarrhea. In 1939 Lawrence 4 reported in vitro studies in which sulfathiazolc was found to be the most effective of the sulfonamide drugs against the colon-typhoid dysentery organisms. Below sulfathiazole in effectiveness were sulfapyridine, sulfaphenylthiazole, and sulfanilamide, in that order. Cooper and Keller, '~ comparing the effectiveness of sulfathiazole , sulfapyridine, sulfamethylthiazole, and sulfanilamide, in protecting mice against fatal doses of Shigelta paradysenteriae Flexner, found sulfathiazole to be the most effective and sulfanilamide to be the least effective. Libby's ~ work revealed that, in vitro, sulfathiazole is more effective against the Flexner dysentery bacillus than were the other sulfanilamide compounds. Taylor 7 concluded that sulfathiazole is effective in the treatment of children with parenteral diarrhea or bacillarY dysentery, particularly in the latter. Good results in the sulfathiazole treatment of infectious diarrhea have been reported by other workers; s-4~ some of these studies, however, were inadequately controlled. Since completing this study, Cooper and his associates 1~ have published their results from a similar study, concluding that suls is of greater therapeutic value in those patients whose stool cultures are positive for dysentery organisms than in the treatment of patients whose stools are negative for these pathogens. This conclusion agrees in the main with our findings. The children included in the present study entered the Cook County Children's Hospital because of frequent, watery stools containing blood and mucus. They were, in general, somewhat less severely ill than those