RANDOMIZED TRIAL OF SINGLE-DOSE CIPROFLOXACIN FOR TRAVELERS DIARRHEA

Diarrhoea is the most common illness affecting travellers to developin g countries. Our study was compare the efficacy of a single 500 ciprof loxacin with placebo for treatment of acute diarrhoea in travellers. B ritish troops who were within their first 8 weeks of deployment in Bel ize and who presented within 24 h of the onset of diarrhoea, were rand omised to receive either ciprofloxacin 500 mg or placebo. Every subjec t recorded the number and consistency of stools and presence of any ot her associated symptoms for 72 h or until recovery. Of 88 subjects enr olled, 83 were evaluable, of whom 45 received ciprofloxacin and 38 pla cebo. Groups did not differ with regard to duration or severity of dia rrhoea at randomisation. Mean (SE) duration of diarrhoea, as assessed by time to the last liquid and last unformed stool, was reduced from 5 0.4 (4.5) h and 53.5 (4.4) h, respectively, in the placebo group to 20 .9 (3.4) h and 24.8 (3.8) h in those receiving ciprofloxacin (p<0.0001 ). Mean number of liquid stools was reduced from 11.4 (1.2) in the pla cebo group to 5.0 (0.7) in the ciprofloxacin-treated group (p<0.0001). The cumulative percentages of subjects with no unformed stool after 2 4 h, 48 h, and 72 h were, respectively, 64%, 82%, and 93% in the cipro floxacin group and 11%, 42%, and 79% in the placebo group (p<0.0001, p <0.001, and not significant, respectively). A single 500 mg dose of ci profloxacin was an effective empirical treatment for reducing the dura tion and severity of diarrhoea in travellers. The regimen should maxim ise compliance and reduce the cost and duration of therapy.