EFFICACY OF OCTREOTIDE IN DIARRHEA DUE TO VIBRIO-CHOLERAE - A RANDOMIZED, CONTROLLED TRIAL

Although octreotide, a long-acting analogue of somatostatin, is curren tly used in the treatment of chronic secretory diarrhoea due to variou s causes, its role in the management of acute secretory diarrhoea is n ot well established. In the present study, therefore, the therapeutic value of octreotide in the management of cholera, a classical example of acute secretory diarrhoea, was investigated. During an outbreak of cholera, patients admitted with acute secretory diarrhoea of less than or equal to 24 h duration and a purging rate >100 ml/h were enrolled on the study and randomly assigned to octreotide (N=17) and control (N =16) groups. All 33 patients received intravenous fluid replacement an d antibiotic treatment (200 mg ofloxacin twice daily for 3 days, by mo uth). Each patient in the octreotide group was also given a subcutaneo us injection containing 100 mu g octreotide every 8 h for a maximum of six doses. The stool output of each patient was recorded every hour u ntil there had been none for an hour, which was taken as the endpoint. Mean (S.D.) total stool output was lower [6.56 (3.7) v. 9.7 (6.5) lit res] and the mean (S.D.) duration of diarrhoea after admission was sho rter [32.9 (15.6) v. 47.8 (22.3); P<0.05] in the octreotide group than in the control group. However, as both groups generally had similar p urging rates, the higher volume of stools from the control group was s imply the result of the longer period of diarrhoea in this group. Octr eotide therefore only decreased the duration of diarrhoea in the chole ra patients.