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Single-Dose Azithromycin Treats Severe Cholera in Adults

Drug works better than a single dose of ciprofloxacin to subdue diarrhea and vomiting

WEDNESDAY, June 7 (HealthDay News) -- A single dose of azithromycin is more effective than a single dose of ciprofloxacin to treat cholera in adults, according to a report in the June 8 issue of the New England Journal of Medicine.

Debasish Saha, M.B., B.S., of the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh, and colleagues compared the effects of azithromycin and ciprofloxacin, each administered in a single dose of two 500-mg tablets, on 195 men with severe cholera.

The researchers found that 73 percent of patients on azithromycin achieved clinical success, meaning no more watery stools within two days of taking the drug, versus 27 percent on ciprofloxacin; 78 percent of azithromycin patients achieved bacteriological success, meaning no evidence of Vibrio cholerae O1 or O139, versus 10 percent on ciprofloxacin. Those taking azithromycin also had shorter bouts of diarrhea, less vomiting and fewer stools.

"Single-dose azithromycin was effective in the treatment of severe cholera in adults," the authors write. "The lack of efficacy of ciprofloxacin may result from its diminished activity against V. cholerae O1 strains currently circulating in Bangladesh."

In an editorial, Richard L. Guerrant, M.D., of the University of Virginia in Charlottesville, and cofounder of AlGlutamine, a developer of oral rehydration therapy, writes that "our reliance on curative antimicrobial agents is misplaced. We must increasingly relearn that no one should lack access to basic clean water and sanitation."

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