Many chemotherapeutic agents can alleviate the symptoms of acute bacillary dysentery and suppress the causative organisms. In chronic Shigella infection, however, most agents have only limited usefulness. In an institution for mentally defective children 93% of 116 fresh cases of shigellosis responded to conventional chemotherapeutic measures, but only 63% of 78 chronic cases.Polymyxin B and E are highly bactericidal for Shigella organisms in vitro. These drugs are stable and are not significantly absorbed from the intestinal tract when taken by mouth. Twenty-three children with chronic intestinal infections due to Shigella paradysenteriae (Flexner) were given daily oral doses of 15 to 20 mg./kg. polymyxin for 10 days. Twenty (87%) were unequivocally cured of their infection which had previously resisted therapy with sulfonamides and other antimicrobial agents. No toxic side-effects were observed. Polymyxin appears to be a useful drug for the oral treatment of chronic Shigella infection.
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