Treatment of Diarrhea in Malnourished Infants and Children: A Double-Blind Study Comparing Ampicillin and Placebo

Rectal swabs and stool specimens for culture were collected from 2,236 infants and children hospitalized for severe diarrhea in Medellin, Colombia, during a two-year period. Salmonellae were identified in 280, enteropathogenic Escherichia coli in 117, and shigellae in 61 specimens. One hundred eighty-six patients with enteropathogens and 96 with acute diarrhea of unknown cause were assigned randomly to ampicillin or placebo treatment given parenterally or orally for five days. No adverse or beneficial effect of ampicillin was found in infants with enteropathogenic E coli or with diarrhea of unknown cause. For Salmonella infection, orally given ampicillin was equivalent to placebo therapy; however, there was 100% bacteriologic cure without short-term relapse in those given ampicillin intramuscularly. This was a statistically significant difference from placebo or orally given ampicillin treatment. Ampicillin therapy for shigellosis substantially shortened the period of diarrhea, fever and, positive stool cultures compared with placebo treatment.