Featured Research

from universities, journals, and other organizations

Clinical trial recommends new antibiotic for treating typhoid in low income countries

Date:
April 28, 2011
Source:
Wellcome Trust
Summary:
A large clinical trial in Kathmandu, Nepal, comparing treatments for typhoid has recommended the use of gatifloxacin, a new generation and affordable antibiotic.

A large clinical trial comparing treatments for typhoid has recommended the use of gatifloxacin, a new generation and affordable antibiotic. The results of the trial in Kathmandu, Nepal, funded by the Wellcome Trust and the Li Ka Shing Foundation, are published in the Lancet Infectious Diseases.

Typhoid -- also known as 'enteric fever' -- is characterised by a high fever and diarrhea. It is transmitted through the ingestion of food or drink contaminated by the faeces or urine of infected people. It causes an estimated 26 million infections each year and over 200,000 deaths and the number of cases is particularly high in parts of South Asia.

The standard treatment for enteric fever since the 1950s was the drug chloramphenicol. The spread of multi-drug resistant forms of the Salmonella typhi and Salmonella paratyphi bacteria which cause the disease saw a move towards a new generation of antibiotics known as fluoroquinolones, but now there is evidence that the bacteria are becoming resistant to even these drugs.

Gatifloxacin -- a new type of fluoroquinolone -- was released in North America in 1999 under the brand name Tequin by the pharmaceutical company Bristol-Myers Squibb, but was subsequently withdrawn following the publication in 2006 of a retrospective Canadian study in the New England Journal of Medicine which claimed that the drug can cause serious side effects including very high and low blood sugars..

In their study, researchers from the Wellcome Trust Major Overseas Programme at the Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam, together with researchers at the Oxford University Clinical Research Unit-Patan Academy of Health Sciences, Kathmandu, Nepal, conducted an open-label, randomised, controlled trial to compare gatifloxacin against chloramphenicol. Their study, which enrolled 844 children and adults, is the largest randomised controlled trial for enteric fever carried out to date.

The researchers found both drugs to be equally effective. They found no difference between the two drugs in terms of treatment failure and the time to clear the fever. However, the side effects, including anorexia, nausea, diarrhea and dizziness, were significantly worse in patients being treated with chloramphenicol.

An added advantage of gatifloxacin over chloramphenicol is that the former only needs to be take once a day for seven days and the average cost for this treatment course is US$1.50. Chloramphenicol, on the other hand, needs to be take four times a day for fourteen days at an average price for the course of US$7. Gatifloxacin appears to work despite drug resistance to the older antibiotics (chloramphenicol and older fluoroquinolones) and can therefore be used in settings where the pattern of resistance is not known.

Because of concerns of the side effects of gatifloxacin in an elderly North American population, the researchers closely monitored the patients' blood sugar levels. Although they found a higher number of patients with elevated blood sugar levels during the first week of treatment, these levels had returned to normal once the treatment course had ended and no change in treatment was required.

"Although there have been concerns of the side effects of gatifloxacin in elderly people from North America, this was amongst a very different population to those needing the drug in the developing world," says Dr Buddha Basnyat. "Gatifloxacin remains a very effective drug in young people who are not overweight and who have no tendency to diabetes.

"We have very few antibiotics for diseases of the developing world and it is very important that we do not lose the effective ones we have because of adverse events in a different population that we do not see in the population we treat."

The researchers have now submitted evidence to the World Health Organization (WHO) arguing that Gatifloxacin should be retained in young populations not at risk of diabetes. It is understood that the WHO will consider this evidence later this year. The drug is also in Phase III trials for treatment of tuberculosis.


Story Source:

The above story is based on materials provided by Wellcome Trust. Note: Materials may be edited for content and length.


Journal Reference:

  1. Amit Arjyal et al. Gatifloxacin versus chloramphenicol for uncomplicated enteric fever: an open-label, randomised, controlled trial. Lancet Infectious Diseases, 2011; DOI: 10.1016/S1473-3099(11)70089-5

Cite This Page:

Wellcome Trust. "Clinical trial recommends new antibiotic for treating typhoid in low income countries." ScienceDaily. ScienceDaily, 28 April 2011. <www.sciencedaily.com/releases/2011/04/110428201114.htm>.
Wellcome Trust. (2011, April 28). Clinical trial recommends new antibiotic for treating typhoid in low income countries. ScienceDaily. Retrieved October 20, 2014 from www.sciencedaily.com/releases/2011/04/110428201114.htm
Wellcome Trust. "Clinical trial recommends new antibiotic for treating typhoid in low income countries." ScienceDaily. www.sciencedaily.com/releases/2011/04/110428201114.htm (accessed October 20, 2014).

Share This



More Health & Medicine News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

How Nigeria Beat Its Ebola Outbreak

How Nigeria Beat Its Ebola Outbreak

Newsy (Oct. 20, 2014) The World Health Organization has declared Nigeria free of Ebola. Health experts credit a bit of luck and the government's initial response. Video provided by Newsy
Powered by NewsLook.com
Another Study Suggests Viagra Is Good For The Heart

Another Study Suggests Viagra Is Good For The Heart

Newsy (Oct. 20, 2014) An ingredient in erectile-dysfunction medications such as Viagra could improve heart function. Perhaps not surprising, given Viagra's history. Video provided by Newsy
Powered by NewsLook.com
Ebola Worries End for Dozens on U.S. Watch Lists

Ebola Worries End for Dozens on U.S. Watch Lists

Reuters - US Online Video (Oct. 20, 2014) Forty-three people who had contact with Thomas Eric Duncan, the first person diagnosed with Ebola in the U.S., were cleared overnight of twice-daily monitoring after 21 days of showing no symptoms. Rough Cut (no reporter narration). Video provided by Reuters
Powered by NewsLook.com
Fauci: Ebola Protocols to Focus on Training

Fauci: Ebola Protocols to Focus on Training

AP (Oct. 20, 2014) Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, says he expects revised CDC protocols on Ebola to focus on training, observation and ensuring health care workers are more protected. (Oct. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins