Treatment of Traveler's Diarrhea with Ciprofloxacin and Loperamide

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 ciproftoxacin with loperamide, or a 3-day course of 50...

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Bibliographic Details
Published in:The Journal of infectious diseases 1992-03, Vol.165 (3), p.557-560
Main Authors: Petruccelli, Bruno P., Murphy, Gerald S., Sanchez, Jose L., Walz, Stephen, DeFraites, Robert, Gelnett, Jane, Haberberger, Richard L., Echeverria, Peter, Taylor, David N.
Format: Article
Language:English
Subjects:
Antibiotics
Biological and medical sciences
Campylobacter
Campylobacter Infections - drug therapy
Ciprofloxacin - therapeutic use
Concise Communications
Diarrhea
Diarrhea - drug therapy
Diseases
Dosage
Double-Blind Method
Drug Therapy, Combination
Dysentery, Bacillary - drug therapy
Escherichia coli Infections - drug therapy
Humans
Infectious diseases
Liquids
Loperamide - therapeutic use
Medical sciences
Military Personnel
Pathogens
Placebos
Relapse
Salmonella Infections - drug therapy
Thailand
Travel
Travelers
United States
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Summary: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 ciproftoxacin 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.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/165.3.557