Single dose azithromycin versus ciprofloxacin for cholera in children: A randomized controlled trial

Kaushik, Jaya Shankar; Gupta, Puneet; Faridi, M. M. A.; Das, Shukla

doi:10.1007/s13312-010-0059-5

Cited by 33 publications

(23 citation statements)

References 12 publications

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“…Three trials compared erythromycin with ciprofloxacin (Khan 1995a BGD; Khan 1995b BGD; Saha 2005 BGD) and found no statistically significant differences (data not shown).…”

Section: Resultsmentioning

confidence: 99%

“…The three trials compared tetracycline 500 mg four times daily for three days with: ciprofloxacin 1 g single dose (Khan 1995a BGD); ciprofloxacin 250 mg once daily for three days (Gotuzzo 1995 PER); and norfloxacin 400 mg twice daily for three days (Moolasarat 1998 THA). …”

Section: Resultsmentioning

confidence: 99%

“…Four trials were included overall, with three of the trials having a similar treatment duration (single dose) (Dutta 1996 IND; Khan 1995a BGD; Khan 1996 BGD) and one trial having a longer duration (Usubutun 1997 TUR). Ciprofloxacin was examined in three trials and norfloxacin in one trial (Dutta 1996 IND).…”

Section: Resultsmentioning

confidence: 99%

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Antimicrobial drugs for treating cholera

Leibovici-Weissman

Neuberger

Bitterman

et al. 2014

Cochrane Database of Systematic Reviews

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Background Cholera is an acute watery diarrhoea caused by infection with the bacterium Vibrio cholerae, which if severe can cause rapid dehydration and death. Effective management requires early diagnosis and rehydration using oral rehydration salts or intravenous fluids. In this review, we evaluate the additional benefits of treating cholera with antimicrobial drugs. Objectives To quantify the benefit of antimicrobial treatment for patients with cholera, and determine whether there are differences between classes of antimicrobials or dosing schedules. Search methods We searched the Cochrane Infectious Disease Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; African Index Medicus; LILACS; Science Citation Index; metaRegister of Controlled Trials; WHO International Clinical Trials Registry Platform; conference proceedings; and reference lists to March 2014. Selection criteria Randomized and quasi‐randomized controlled clinical trials in adults and children with cholera that compared: 1) any antimicrobial treatment with placebo or no treatment; 2) different antimicrobials head‐to‐head; or 3) different dosing schedules or different durations of treatment with the same antimicrobial. Data collection and analysis Two reviewers independently applied inclusion and exclusion criteria, and extracted data from included trials. Diarrhoea duration and stool volume were defined as primary outcomes. We calculated mean difference (MD) or ratio of means (ROM) for continuous outcomes, with 95% confidence intervals (CI), and pooled data using a random‐effects meta‐analysis. The quality of evidence was assessed using the GRADE approach. Main results Thirty‐nine trials were included in this review with 4623 participants. Antimicrobials versus placebo or no treatment Overall, antimicrobial therapy shortened the mean duration of diarrhoea by about a day and a half compared to placebo or no treatment (MD ‐36.77 hours, 95% CI ‐43.51 to ‐30.03, 19 trials, 1013 participants, moderate quality evidence ). Antimicrobial therapy also reduced the total stool volume by 50% (ROM 0.5, 95% CI 0.45 to 0.56, 18 trials, 1042 participants, moderate quality evidence ) and reduced the amount of rehydration fluids required by 40% (ROM 0.60, 95% CI 0.53 to 0.68, 11 trials, 1201 participants, moderate quality evidence ). The mean duration of fecal excretion of vibrios was reduced by almost three days (MD 2.74 days, 95% CI ‐3.07 to ‐2.40, 12 trials, 740 participants, moderate quality evidence). There was substantial heterogeneity in the size of these benefits, probably due to differences in the antibiotic used, the trial methods (particularly effective randomization), and the tim...

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“…Three trials compared erythromycin with ciprofloxacin (Khan 1995a BGD; Khan 1995b BGD; Saha 2005 BGD) and found no statistically significant differences (data not shown).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Antimicrobial drugs for treating cholera

Leibovici-Weissman

Neuberger

Bitterman

et al. 2014

Cochrane Database of Systematic Reviews

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“…Azithromycin may be dosed 500 to 1000 mg daily for 1 to 3 days with pediatric dosing of 10 mg/kg/d for 3 days. 26 A fluoroquinolone such ciprofloxacin 500 mg 2 times daily for 3 days is an alternate drug choice in adults. 22 Aggressive oral rehydration will prevent severe illness, as many individuals with TD will suffer from mildto-moderate dehydration.…”

Section: Travelers' Diarrheamentioning

confidence: 99%

Management of Travel-Related Illness Acquired in Haiti

Walters

2015

Nursing Clinics of North America

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“…The efficacy of ORS treatment is exemplified in a case study from the 70s in which cholera mortality could be decreased among Bangladesh refugees to 3.6% by administration of ORS, compared to 30% in similar refugee camps that relied purely on intravenous fluid substitution therapy [195]. In addition to rehydration therapy, a single-dose administration of azithromycin has been shown to ameliorate disease severity [196,197]. Apart from these strategies, our specific therapeutic resources are limited.…”

Section: The Pathophysiology Of Enterotoxin Mediated Diarrheamentioning

confidence: 99%

Toxin Mediated Diarrhea in the 21st Century: The Pathophysiology of Intestinal Ion Transport in the Course of ETEC, V. cholerae and Rotavirus Infection

Kopic

Geibel

2010

Toxins

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An estimated 4 billion episodes of diarrhea occur each year. As a result, 2–3 million children and 0.5–1 million adults succumb to the consequences of this major healthcare concern. The majority of these deaths can be attributed to toxin mediated diarrhea by infectious agents, such as E. coli, V. cholerae or Rotavirus. Our understanding of the pathophysiological processes underlying these infectious diseases has notably improved over the last years. This review will focus on the cellular mechanism of action of the most common enterotoxins and the latest specific therapeutic approaches that have been developed to contain their lethal effects.

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Single dose azithromycin versus ciprofloxacin for cholera in children: A randomized controlled trial

Abstract: Single dose azithromycin is superior to ciprofloxacin for treating cholera in children.

Cited by 33 publications

References 12 publications

Antimicrobial drugs for treating cholera

Antimicrobial drugs for treating cholera

Management of Travel-Related Illness Acquired in Haiti

Toxin Mediated Diarrhea in the 21st Century: The Pathophysiology of Intestinal Ion Transport in the Course of ETEC, V. cholerae and Rotavirus Infection

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