New treatment option for childhood cholera

September 13, 2005

Researchers in Bangladesh have found that severe cholera in children can be treated effectively with a single dose of the antibiotic ciprofloxacin, according to a study published online by The Lancet.

Cholera is a major global health problem particularly in children in areas in less-developed countries. In the resource-limited countries where cholera occurs, any reduction in hospital stay is important as it reduces the demands on the healthcare system. Currently, WHO recommends a 3-day, 12-dose course of antibiotic treatment with either tetracycline or erythromycin for treatment of cholera in children.

Debasish Saha (Centre for Health and Population Research, Bangladesh) and colleagues compared the effectiveness of a 3-day, 12-dose course of erythromycin with a single-dose of ciprofloxacin. 162 children were randomly assigned to treatment with either ciprofloxacin or erythromycin. Treatment with ciprofloxacin was successful within 48 hours in 60% of cases, compared with 55% in children who were treated with erythromycin. Ciprofloxacin was more effective than erythromycin at reducing vomiting and stool number and volume. However, single-dose ciprofloxacin was inferior to erythromycin in eradicating the cholera bacteria--Vibrio cholerae--resulting in those treated with ciprofloxacin excreting the bacteria for longer than those treated with erythromycin.

Dr Saha concludes: "For infections caused by susceptible strains of V cholerae, single-dose ciprofloxacin achieves clinical outcomes similar to or better than, those achieved with 12-dose erythromycin treatment in childhood cholera, but is less effective in eradicating V cholerae from stool"
-end-
See also accompanying Comment also published early online.

Dr Debasish Saha, Clinical Sciences Division, ICDDR, B, GPO Box-128, Dhaka 1000, Bangladesh.

Lancet

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