Treatment of travelers' diarrhea: ciprofloxacin plus loperamide compared with ciprofloxacin alone: a placebo-controlled, randomized trial

Article Abstract:

Travelers' diarrhea is not limited to vacationers. United States military personnel on duty in other parts of the world often suffer from diarrheal illnesses. Previous studies have shown that the antibiotic ciprofloxacin can reduce the typical length of the illness from three or four days to one day, and may offer some benefits over trimethoprim-sulfamethoxazole, another antibiotic used for travelers' diarrhea, and to which some of the causative bacteria are becoming resistant. Some other studies have suggested that the use of loperamide, an agent that slows the muscular activity of the gut, may improve symptoms. A group of American soldiers stationed in Egypt for military maneuvers who developed diarrhea were assigned to receive either ciprofloxacin and loperamide or ciprofloxacin and a placebo, and assessed for resolution of symptoms. The conditions of the patients given both ciprofloxacin and loperamide improved somewhat more rapidly during the first 24 hours, but by 48 hours, both groups had a 90 percent improvement rate. Thus, ciprofloxacin appears to be an effective agent for travelers' diarrhea, but adding loperamide does not appear to add substantial benefit. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Diarrhea, Drug therapy, Combination, Combination drug therapy

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Ciprofloxacin and loperamide in the treatment of bacillary dysentery

Article Abstract:

Combining loperamide with the antibiotic ciprofloxacin in the treatment of bacillary dysentery appears to be more effective than ciprofloxacin alone. Loperamide is an antidiarrheal drug which works by slowing intestinal motility, and anti-motility drugs have not traditionally been recommended for treating dysentery. Of 88 patients with dysentery, 42 took loperamide and 46 took placebo. The 44 patients with bacillary dysentery were also treated with ciprofloxacin. Patients who took loperamide had an average of 4.5 diarrheal stools compared with seven stools among patients who took placebo. Furthermore, in patients with dysentery caused by the bacterium Shigella, loperamide plus ciprofloxacin shortened the duration of the illness. Among patients with bacillary dysentery, those who took loperamide and those who took placebo showed no significant differences in the percentage who experienced cramps, vomiting and nausea.

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Comparison of azithromycin and ciprofloxacin: a double-blind, randomized, controlled trial

Article Abstract:

Azithromycin appears to be effective in treating patients with Shigella infections. Stool frequency and consistency were evaluated and stool cultures were examined for Shigella organisms during five days of either azithromycin or ciprofloxacin treatment among 70 men with shigellosis. There was no evidence of Shigella organisms in stool samples following treatment among 94% of the patients taking azithromycin and all of the patients taking ciprofloxacin. Watery or bloody diarrhea did not persist nor was a fever documented among 82% of patients treated with azithromycin and 89% of patients treated with ciprofloxacin.

Azithromycin

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