Norfloxacin compared to trimethoprim/sulfamethoxazole for the treatment of travelers' diarrhea among U.S. military personnel deployed to South America and West Africa

S. A. Thornton, S. F. Wignall, M. E. Kilpatrick, Louis Bourgeois, C. Gardiner, R. A. Batchelor, D. H. Burr, J. J. Oprandy, P. Garst, K. C. Hyams

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Abstract

A randomized treatment trial of travelers' diarrhea was carried out among U.S. military personnel participating in routine exercises in several port cities in South America and West Africa. A 5-day, twice daily course of either norfloxacin (400 mg) or trimethoprim/sulfamethoxazole (TMP/SMX, 160/800 mg) was given to 142 volunteers. At the end of 5 days of treatment, diarrhea had resolved in 100% of 73 patients receiving norfloxacin and 97.1% (67/69) receiving TMP/SMX. A probable bacterial pathogen was determined in 44% of 142 subjects: 49% of the norfloxacin group and 39% of the TMP/SMX group. The most common pathogens detected were enterotoxigenic Escherichia coli in 20% of cases and rotavirus in 15%. Resistance to TMP/SMX was present in 20 (27%) bacterial isolates, while no resistance to norfloxacin was found. Eight of 10 patients in the TMP/SMX treatment group who had TMP/SMX-resistant bacterial enteropathogens improved clinically. Both norfloxacin and TMP/SMX were clinically effective in the treatment of traveler's diarrhea in this military population.

Original languageEnglish (US)
Pages (from-to)55-58
Number of pages4
JournalMilitary Medicine
Volume157
Issue number2
Publication statusPublished - 1992
Externally publishedYes

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ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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