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Bicozamycin, A Poorly Absorbable Antibiotic, Effectively Treats Travelers' Diarrhea

CHARLES D. ERICSSON, M.D.; HERBERT L. DuPONT, M.D.; PEGGY SULLIVAN, M.S.; EMMA GALINDO, Q.F.B.; DOLORES G. EVANS, Ph.D.; and DOYLE J. EVANS Jr., Ph.D.
[+] Article and Author Information

Grant support: contract NO1AI02662, National Institute of Allergy and Infectious Diseases, National Institutes of Health; and a grant from CIBA/GEIGY, Ltd., Basel, Switzerland.

Presented in part July 1981, at the 12th International Congress of Chemotherapy, Florence, Italy; October 1981, at the 17th U.S.-Japan Joint Cholera Conference, Baltimore Maryland; and November 1981, at the 21st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, Illinois.

▸Requests for reprints should be addressed to Charles D. Ericsson, M.D.; University of Texas Medical School, 1722 Freeman Building, 6431 Fannin Street; Houston, TX 77030.


Houston, Texas; and Mexico City, Mexico


©1983 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1983;98(1):20-25. doi:10.7326/0003-4819-98-1-20
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The efficacy of bicozamycin, a poorly absorbable antibiotic, in the treatment of acute diarrhea was assessed in a prospective, double-blind study of 140 adults from the United States visiting Guadalajara, Mexico. Patients randomly received bicozamycin (500 mg orally four times daily) or placebo for 3 days. The mean duration of illness was shorter in the bicozamycin than the placebo treatment groups for patients with diarrhea due to Shigella (37 versus 90 hours; p = 0.01), toxigenic Escherichia coli (31 versus 60 hours; p = 0.003), and unknown pathogens (18 versus 41 hours; p = 0.02). Cramps were significantly relieved by bicozamycin in all patients. Treatment failed in significantly fewer patients treated with bicozamycin than those treated with placebo when diarrhea was associated with Shigella, Salmonella or toxigenic E. coli. Bicozamycin was well tolerated and appears to be effective therapy for acute travelers' diarrhea of diverse causes. These data show the value of an antibiotic in the therapy of toxigenic E. coli infection and indicate a need to reevaluate the clinical dictum that nonabsorbable antibiotics are ineffective against invasive enteropathogens.

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