Antibiotic Therapy for Invasive Bacterial Diarrhea

To evaluate the effectiveness of the standard practice of antibiotic prescribing in diarrheal diseases (DD) at Palembang General Hospital, we performed this single blind clinical trial. Subjects were children with DD, without E. histolytica.. or G. Iamblia in their stool, 6 to 59 months of age, seen at the OPD from May 20, 1991 until March 31, 1992. Antibiotic treatment (AT) was given to the treated group (n=289), and was withheld from the control group (n=298). The effectiveness of antibiotic treatment was measured by rate of reconsultation, need for subsequent AT, duration of diarrhea, vomiting, and fever as measured by home visitors. The treated group has a significantly shorter duration of diarrhea and a significant difference in the need for additional AT. Subjects whose diarrhea persist more than 7 days were significant statistically only in bloody diarrhea and in subjects whose fecal leukocytes were more than 9 per high power field. Profuse diarrhea and mother's anxiety were the main reasons for further consultation, which were strikingly greater in control than in treated group. Mothers seeked reconsultation 12.5 times more often for bloody diarrhea and 19.5 times for mucoid diarrhea plus fever. This study reconfirmed that AT in DD shortens the duration of diarrhea, diminishes the rate of reconsultation, and need for subsequent antibiotics in bloody and mucoid diarrhea.