Efficacy of bicozamycin in preventing traveler's diarrhea

Ericsson, Charles D.; DuPont, Herbert L.; Galindo, E; Mathewson, John J.; Morgan, D. R.; Wood, Lindsey; Mendiola, Jaime

doi:10.1016/0016-5085(85)90509-8

Cited by 28 publications

(11 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 88% rate of protection afforded by norfloxacin compares favorably with rates of 59 to 95% afforded by other antibiotics studied previously in controlled trials (4,6,(14)(15)(16)(17). The lowest rate, 68%, occurred in the group of Peace Corps volunteers taking doxycycline in areas where doxycycline resistance had been documented (16).…”

Section: Discussionmentioning

confidence: 70%

See 1 more Smart Citation

Lack of emergence of resistant fecal flora during successful prophylaxis of traveler's diarrhea with norfloxacin

Johnson¹,

Ericsson²,

Morgan³

et al. 1986

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Norfloxacin, a new quinolone carboxylic acid derivative, was compared with an identical-appearing placebo preparation in a prospective, randomized, double-blind trial for prevention of traveler's diarrhea among 120 U.S. students arriving in Mexico. Prophylaxis was continued for 2 weeks. Diarrhea was defined as four unformed stools in 24 h plus an additional symptom of enteric disease. In the norfloxacin prophylaxis group, 4 of 56 subjects (7%) experienced diarrhea, compared with 36 of 59 subjects (61%) in the placebo group. The difference was significant (P less than 0.0001). In contrast to our previous experience with use of trimethoprim-sulfamethoxazole to prevent traveler's diarrhea, quantitative stool cultures in the norfloxacin-treated group revealed a significant decline of normal aerobic fecal flora during prophylaxis (P less than 0.0005). Among stool samples from norfloxacin-treated subjects, 32 of 38 (84%) cultured on day 7 and 34 of 37 (92%) cultured on day 14 had no gram-negative bacilli. After norfloxacin was discontinued, fecal flora returned to pretreatment levels. No gram-negative aerobic flora resistant to norfloxacin were found during weekly quantitative cultures before, during, or after therapy.

show abstract

Section: Discussionmentioning

confidence: 70%

“…Recent placebo-controlled studies of doxycycline (14)(15)(16), trimethoprim-sulfamethoxazole (TMP-SMX) (4), trimethoprim alone (4), and bicozamycin (6) have shown that these agents effectively prevent traveler's diarrhea. TMP-SMX resistance among enteric bacterial pathogens is becoming more common in several areas of the developing world (13,20).…”

mentioning

confidence: 99%

Lack of emergence of resistant fecal flora during successful prophylaxis of traveler's diarrhea with norfloxacin

Johnson¹,

Ericsson²,

Morgan³

et al. 1986

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…In the 1980s, poorly absorbed bicozamycin was evaluated and found effective as a preventive drug for TD, 48 although the drug has not since been developed for human use. Rifaximin, a poorly absorbed (<0.4%) rifamycin antibiotic with in vitro activity against enteric bacterial pathogens important in TD, 36 was shown to be effective in treating TD 49 .…”

Section: Chemoprophylaxismentioning

confidence: 99%

Systematic review: prevention of travellers’ diarrhoea

DuPont

2008

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…At the time of enrollment, each subject submitted a fresh unformed stool that was examined for the presence of mucus, frank and occult blood, fecal leukocytes, parasites, and enteric pathogens by standard laboratory methods at the field laboratory (7,9). Five colonies of predominant E. coli-like organisms were saved and studied in Houston for the presence of enterotoxigenic E. coli by Y-1 adrenal cell assay for heat-labile enterotoxin, and by suckling mouse assay for heat-stable enterotoxin (9).…”

Section: Methodsmentioning

confidence: 99%

Role of a novel antidiarrheal agent, BW942C, alone or in combination with trimethoprim-sulfamethoxazole in the treatment of traveler's diarrhea

Ericsson¹,

Johnson²,

DuPont³

et al. 1986

Antimicrob Agents Chemother

View full text Add to dashboard Cite

The efficacy of BW942C, a novel enkephalinlike pentapeptide antidiarrheal agent, was compared with the efficacy of trimethoprim-sulfamethoxazole (TMP-SMX) and the combination of the two agents in a placebocontrolled trial of the 72-h treatment of acute diarrhea. Subjects with diarrhea but without bloody stools or fever greater than 102°F (38.9°C) were enrolled. Administered to 134 U.S. adults with diarrhea that developed shortly after their arrival in Guadalajara, Mexico, BW942C was more efficacious than TMP-SMX in relieving diarrhea and cramps in the first 12 h of therapy, especially among subjects with diarrhea caused by enterotoxigenic E. coli. In the BW942C treatment group, 25% of subjects eventually took additional therapy because their diarrhea did not respond to BW942C alone. Neurological side effects such as dizziness and light-headedness occurred more frequently among BW942C-treated subjects. Therapy for 3 days with TMP-SMX provided lasting relief comparable with previously reported 5-day therapy. Use of the combination of both agents provided the benefits of prompt relief afforded by BW942C and lasting relief afforded by TMP-SMX. BW942C might prove to be an agent suitable for the treatment of acute diarrhea, with TMP-SMX reserved for treatment of those who do not respond adequately. The empiric use of the combination of BW942C and TMP-SMX appears appropriate for the treatment of severe nondysenteric disease.BW942C is a novel, enkephalinlike pentapeptide [Tyr-DMet-(0)-Gly-pNO2-Phe-Pro-NH2 acetate] with demonstrated antidiarrheal properties in animal models and proven antisecretory activity against enterotoxins of Escherichia coli and Vibrio cholerae (10). In preliminary animal studies, BW942C appears to have a low abuse potential, limited effects on the central nervous system, a high therapeutic index, and a rapid onset' of action. In volunteers with castor oil-induced diarrhea, treatment with BW942C compared with placebo led to a decrease in overall stool frequency, abdominal cramping, nausea, and vomiting. The only adverse effects noted were dizziness and dry mouth that occurred more frequently at high dosages (J. Ryan, J.Leighton, D. Kirksey, and G. McMahon, Clin. Pharmacol.Ther., in press).This report examines the efficacy and safety of BW942C used alope as an antidiarrheal agent or in combination with an antibiotic, trimethoprim-sulfamethoxazole (TMP-SMX). The hypothesis was that use of BW942C might prove efficacious compared with placebo and that use of the agent in combination with TMP-SMX might afford earlier relief of diarrhea than is already possible with use of TMP-SMX alone. Although in a previous study TMP-SMX was given for 5 days (5), we administered it for only 3 days in this study in an effort to define a more cost-effective use of this antibiotic. MATERIALS AND METHODSA total of 134 male and female students, newly arrived in Guadalajara, Mexico, from the United States, were enrolled in a prospective, randomized, double-blind study during the summer of 1983. Subjects who presented to the...

show abstract

Efficacy of bicozamycin in preventing traveler's diarrhea

Cited by 28 publications

References 8 publications

Lack of emergence of resistant fecal flora during successful prophylaxis of traveler's diarrhea with norfloxacin

Lack of emergence of resistant fecal flora during successful prophylaxis of traveler's diarrhea with norfloxacin

Systematic review: prevention of travellers’ diarrhoea

Role of a novel antidiarrheal agent, BW942C, alone or in combination with trimethoprim-sulfamethoxazole in the treatment of traveler's diarrhea

Contact Info

Product

Resources

About