Trimethoprim-sulfamethoxazole in the treatment of gastrointestinal infections, including enteric fever and typhoid carriers.

Forty-three patients suffering from typhoid fever, 11 from paratyphoid fever, six from bacillary dysentery caused by Shigella flexneri, and nine carriers of Salmonella typhi or S. paratyphi B, have been treated with trimethoprim-sulfamethoxazole compound. Fifty-one of the 54 patients who had typhoid fever or paratyphoid fever responded satisfactorily to treatment. Two patients with typhoid fever failed to respond and one died. In the patients with bacillary dysentery acute symptoms subsided rapidly within 24 hours of starting trimethoprim-sulfamethoxazole. Seven of the nine typhoid or paratyphoid carriers have been followed up after treatment and only one remains a fecal excretor of S. typhi. Five patients in the series developed a skin rash during therapy, one a macrocytic anemia and one reversible neutropenia. It is concluded that trimethoprim-sulfamethoxazole is an effective agent for the treatment of enteric fever, severe bacillary dysentery and typhoid carriers.