PRACTICAL GUIDELINES FOR THE TREATMENT OF CHOLERA

Cholera is a dramatic clinical illness that requires rapid diagnosis a nd aggressive therapy. Clinical signs and symptoms of mild, moderate a nd severe dehydration must be determined, before beginning fluid thera py, Fluid therapy has 2 phases: rehydration (first 3 to 4 hours to cor rect deficits) and maintenance (to match continuing losses), The route and speed of fluid administration will depend on the degree of dehydr ation. Patients with severe dehydration should be treated intravenousl y, as should those patients who do not tolerate oral rehydration solut ion (ORS). Ringer's lactate is the preferred intravenous solution, alt hough normal saline may be used along with ORS, For most patients with cholera, an ORS using one of the higher sodium-containing solutions a nd plain water optimally provide the fluid and salt needed, Close moni toring of intake, outputs and hydration status should be performed for all patients, Antimicrobial therapy should be given to moderately and severely ill patients in order to decrease the volume of fluids lost and to shorten the period of excretion of vibrios.