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.
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.
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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 -