Antimicrobial Agents in the Prevention of Travelers' Diarrhea

Each of 433 adults traveling to Guadalajara, Mexico, from the United States during summer months was enrolled in one of four clinical trials of the protective effect of antimicrobial agents against travelers' diarrhea. Only one (2%) of 57 subjects taking trimethoprim-sulfamethoxazole (160 mg/80...

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Bibliographic Details
Published in:Reviews of infectious diseases 1986-05, Vol.8 (2), p.S167-S171
Main Authors: Herbert L. Du Pont, Charles D. Ericsson, Johnson, Philip C., Francisco J. Cabada
Format: Article
Language:English
Subjects:
Adult
Anti-Bacterial Agents - therapeutic use
Antidiarrheals - therapeutic use
Antimicrobials
Biological and medical sciences
Bridged Bicyclo Compounds - therapeutic use
Bridged Bicyclo Compounds, Heterocyclic
Clinical Trials as Topic
Diarrhea
Diarrhea - prevention & control
Diseases
Dosage
Drug Combinations - therapeutic use
Dysentery, Bacillary - prevention & control
Escherichia coli
Escherichia coli Infections - prevention & control
Experimentation
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Medical sciences
Norfloxacin - therapeutic use
Pathogens
Placebos
Prevention
Shigella
Sulfamethoxazole - therapeutic use
Travel
Travelers
Trimethoprim - therapeutic use
Trimethoprim, Sulfamethoxazole Drug Combination
Tropical medicine
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Summary:Each of 433 adults traveling to Guadalajara, Mexico, from the United States during summer months was enrolled in one of four clinical trials of the protective effect of antimicrobial agents against travelers' diarrhea. Only one (2%) of 57 subjects taking trimethoprim-sulfamethoxazole (160 mg/800 mg daily) experienced diarrhea during a two-week study, whereas eight (14%) of 58 subjects taking trimethoprim alone (200 mg daily) and 10 (33%) of 30 taking placebo developed illness (P < .05 and P < .0001, respectively). Diarrhea occurred significantly less frequently among subjects receiving trimethoprim than among placebo recipients (P < .05). None of 11 students given bicozamycin (500 mg four times daily) developed diarrhea during a three-week study, whereas 10 (53%) of 19 placebo recipients became ill (P = .003). Four (7%) of 54 subjects receiving norfloxacin (400 mg daily) experienced diarrhea during a two-week study; in contrast, 34 (60%) of 57 placebo recipients developed diarrhea (P < .0001). The various antimicrobial agents prevented illness due to enterotoxigenic Escherichia coli and Shigella as well as that unassociated with a pathogen. The drugs were well tolerated. Current evidence suggests that trimethoprim-sulfamethoxazole is the optimal antimicrobial agent available for prophylaxis of travelers' diarrhea.
ISSN:0162-0886