Norfloxacin Compared to Trimethoprim/ Sulfamethoxazole for the Treatment of Travelers' Diarrhea among U.S. Military Personnel Deployed to South America and West Africa

Thornton, Scott A.; Wignall, Stephen; Kilpatrick, Michael E.; Bourgeois, A. Louis; Gardiner, C. H.; Batchelor, Roger A.; Burr, Donald H.; Oprandy, John J.; Garst, Paul; Hyams, Kenneth C.

doi:10.1093/milmed/157.2.55

Cited by 16 publications

(7 citation statements)

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“…They saw a significant decrease in the number of loose stools and in diarrhea duration among those receiving the study drugs compared to those receiving placebo. This is consistent with studies of travelers' diarrhea treatment with these antibiotics [37][38][39].…”

Section: Model Utilitysupporting

confidence: 92%

A systematic review of experimental infections with enterotoxigenic Escherichia coli (ETEC)

Porter

Riddle

Tribble

et al. 2011

Vaccine

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Section: Model Utilitysupporting

confidence: 92%

A systematic review of experimental infections with enterotoxigenic Escherichia coli (ETEC)

Porter

Riddle

Tribble

et al. 2011

Vaccine

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“…Due to resistance, quinolones have replaced doxycycline and trimethoprim-sulphamethoxazole as drugs of choice for travellers diarrhea, but quinolone resistance has since emerged and is increasing. The only promising alternative is rifaximin, a recently licensed, non-absorbable antimicrobial that can be used to treat infections by non-invasive E. coli pathotypes [85,119,[270][271][272][273]. Availability and costs mean that rifamixin is presently limited to adjusting recommendations for travellers from affluent countries to compensate for the emergence of resistance, a niche occupied until now by ciprofloxacin.…”

Section: Clinically Relevant Unanswered Questions About the Biology Omentioning

confidence: 99%

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Okeke

2009

J Infect Dev Ctries

124

103

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Diarrhea is a leading cause of illness and death, particularly in developing countries. Enteropathogenic Escherichia coli, enterotoxigenic E. coli (ETEC), enteroinvasive E. coli, enterohemorrhaghic E. coli (EHEC), enteroaggregative E. coli (EAEC) and diffusely adherent E. coli (DAEC) have been associated with diarrheal disease in different parts of Africa, particularly among young children, HIV-positive individuals, and visitors from abroad. Each of these E. coli pathotypes uses distinct mechanisms, which are only partially understood, to colonize infected hosts and produce diarrhea. All known diarrheagenic E. coli pathotypes have been reported from diverse locations within Africa but the true burden from these pathogens is unknown because very few studies seeking these organisms with discriminatory methodology have been performed. Recent reports implicate ETEC and EAEC in a considerable proportion of childhood and travellers' diarrheas and suggest that some sub-types of these categories may have greater epidemiological significance than others. The significant contribution of EHEC to bloody diarrhea and hemolytic uremic syndrome is underappreciated because diagnostic capacity for this pathotype is generally inferior to that for confounders such as Shigella and Entamoeba. Recent studies in Africa have revealed the worrisome emergence of antimicrobial resistance and high asymptomatic carriage rates for diarrheagenic E. coli but bacterial and host factors that predispose to disease, as well as non-human reservoirs, are largely unknown. Future diarrheal disease research needs to focus on broadening the repertoire of pathogens sought in epidemiological surveys to include multiple categories of diarrheagenic E. coli while building capacity to detect these pathogens in local reference laboratories.

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“…Multiple studies have shown that effective antibiotic treatment with tetracycline, TMP-SMX, trimethoprim, and fluoroquinolones, in as little as a single dose, generally shortens the duration of illness from 2 to 3 days to 1 day. [122][123][124][125][126] Although resistance to quinolones among ETEC remains low worldwide, resistance is commonly seen in other enteric pathogens, particularly Campylobacter spp. 127 In patients with severe symptoms and/or bloody diarrhea, a 1-to 3-day course of a quinolone (norfloxacin 400 mg bid, ciprofloxacin 500 mg bid, or ofloxacin 300 mg bid all for 3 days), TMP-SMX (160/800 mg bid for 3 days) or azithromycin (500 mg qd for 3 days) is suggested depending on local antibiotic resistance patterns.…”

Section: Inflammatory and Bloody Community-acquired Diarrheamentioning

confidence: 99%

Infectious Diarrhea in Developed and Developing Countries

Cheng¹,

McDonald²,

Thielman³

2005

Journal of Clinical Gastroenterology

108

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Diarrhea from gastrointestinal infection remains a common problem. In industrialized countries, management is aimed at reducing morbidity and defining groups that may benefit from further investigation. Most infectious diarrhea is self-limiting and only requires supportive management. Viral agents are increasingly recognized as causative agents of epidemic and sporadic diarrhea. In developing countries, diarrhea is a major cause of mortality in children. Oral rehydration therapy, guided by a clinical assessment of the degree of dehydration, is cheap, simple, and effective and remains the mainstay of management of infant diarrhea. Controversies focus on the optimal formulation of oral rehydration solution. A vaccine against rotavirus has the potential to save millions of lives worldwide.

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Norfloxacin Compared to Trimethoprim/ Sulfamethoxazole for the Treatment of Travelers' Diarrhea among U.S. Military Personnel Deployed to South America and West Africa

Cited by 16 publications

References 0 publications

A systematic review of experimental infections with enterotoxigenic Escherichia coli (ETEC)

A systematic review of experimental infections with enterotoxigenic Escherichia coli (ETEC)

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Infectious Diarrhea in Developed and Developing Countries

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