Treatment of traveler’s diarrhea with ciprofloxacin and loperamide

Bruno P. Petruccelli, Gerald S. Murphy, Jose L. Sanchez, Stephen Walz, Robert DeFraites, Jane Gelnett, Richard L. Haberberger, Peter Echeverria, David N. Taylor

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)557-560
Number of pages4
JournalJournal of Infectious Diseases
Volume165
Issue number3
DOIs
StatePublished - Mar 1992

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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