Use of oral gentamicin, metronidazole, and cholestyramine in the treatment of severe persistent diarrhea in infants.

Oral gentamicin, metronidazole, and cholestyramine were given either as single agents or in various combinations to infants who still required treatment after seven days in the hospital for persistent diarrhea. The effect of these drugs and the interactions between them were assessed by comparing daily stool output during treatment with that in the pretreatment period. The effect of the drugs on apparent nitrogen and fat absorption was also studied. On the first day of treatment the presence of cholestyramine was associated with a significantly greater decrease in stool output. This effect appeared to be largely due to an interaction with gentamicin. Thereafter, only gentamicin produced a significantly greater decrease in stool weight. At no stage was metronidazole of benefit. Gentamicin and cholestyramine also indirectly improved apparent nitrogen and fat absorption by reducing stool output. The combination of oral gentamicin and cholestyramine is recommended as a safe and effective way of treating infants with severe persistent diarrhea following acute gastroenteritis.