TY - JOUR
T1 - Treatment of traveler’s diarrhea with ciprofloxacin and loperamide
AU - Petruccelli, Bruno P.
AU - Murphy, Gerald S.
AU - Sanchez, Jose L.
AU - Walz, Stephen
AU - DeFraites, Robert
AU - Gelnett, Jane
AU - Haberberger, Richard L.
AU - Echeverria, Peter
AU - Taylor, David N.
N1 - Funding Information:
Received 12 June 1991; revised 1 November 1991. Presented: annual meeting, American Society ofTropical Medicine and Hygiene, New Orleans, 1990. All enrollees gave written informed consent. The opinions expressed herein do not necessarily represent the views of the US Army or Navy. Financial support: Medical Research and Development Commands of the US Army and Navy. Reprints or correspondence: Dr. D. N. Taylor, Department of Enteric Infections, WRAIR, Washington, DC 20307-5100.
PY - 1992/3
Y1 - 1992/3
N2 - To determine the efficacy of loperamide given with long- and short-course quinolone therapy for treating traveler’s diarrhea, 142 US military personnel were randomized to receive a single 750-mg dose of ciprofloxacin with placebo, 750 mg of ciprofloxacin with loperamide, or a 3-day course of 500 mg of ciprofloxacin twice daily with loperamide. Culture of pretreatment stool specimens revealed campylobacters (41%), salmonellae (18%), enterotoxigenic Escherichia coli (ETEC, 6%), and shigellae (4%). Of the participants, 87% completely recovered within 72 h of entry. Total duration of illness did not differ significantly among the three treatment groups, but patients in the 3-day ciprofloxacin plus loperamide group reported a lower cumulative number of liquid bowel movements at 48 and 72 h after enrollment compared with patients in the singledose ciprofloxacin plus placebo group (1.8 vs. 3.6, P =.01; 2.0 vs. 3.9, P =.01). While not delivering a remarkable therapeutic advantage, loperamide appears to be safe for treatment of non-ETEC causes of traveler’s diarrhea. Two of 54 patients with Campylobacter enteritis had a clinical relapse after treatment that was associated with development of ciprofloxacin resistance.
AB - To determine the efficacy of loperamide given with long- and short-course quinolone therapy for treating traveler’s diarrhea, 142 US military personnel were randomized to receive a single 750-mg dose of ciprofloxacin with placebo, 750 mg of ciprofloxacin with loperamide, or a 3-day course of 500 mg of ciprofloxacin twice daily with loperamide. Culture of pretreatment stool specimens revealed campylobacters (41%), salmonellae (18%), enterotoxigenic Escherichia coli (ETEC, 6%), and shigellae (4%). Of the participants, 87% completely recovered within 72 h of entry. Total duration of illness did not differ significantly among the three treatment groups, but patients in the 3-day ciprofloxacin plus loperamide group reported a lower cumulative number of liquid bowel movements at 48 and 72 h after enrollment compared with patients in the singledose ciprofloxacin plus placebo group (1.8 vs. 3.6, P =.01; 2.0 vs. 3.9, P =.01). While not delivering a remarkable therapeutic advantage, loperamide appears to be safe for treatment of non-ETEC causes of traveler’s diarrhea. Two of 54 patients with Campylobacter enteritis had a clinical relapse after treatment that was associated with development of ciprofloxacin resistance.
UR - http://www.scopus.com/inward/record.url?scp=0026604679&partnerID=8YFLogxK
U2 - 10.1093/infdis/165.3.557
DO - 10.1093/infdis/165.3.557
M3 - Article
C2 - 1538160
AN - SCOPUS:0026604679
SN - 0022-1899
VL - 165
SP - 557
EP - 560
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 3
ER -