Oral rehydration therapy plus loperamide versus loperamide alone in the treatment of traveler's diarrhea

Eighty United States students in Mexico received either loperamide (an init ial dose of 4 mg, followed by 2 mg after passage of each unformed stool, up to 8 mg/d; 40 patients) or loperamide (at the same dosage schedule) plus a n oral rehydration therapy (ORT) preparation (500 mt initially, followed by 250 mt after each subsequently passed unformed stool, up to 1,000 mt per 2 4 hours; 40 patients). The ORT preparation was a modification of the World Health Organization-recommended solution, adjusted to a sodium concentratio n of 60 mEq/L. All treatments were given for 48 hours. The study demonstrat ed equivalent clinical responses with regard to diminishment of diarrhea or subjective findings such as abdominal pain/cramps, headache, dry mouth, di zziness, or thirst. Stool number (by form) and specific gravity of urine po stenrollment were similar in the groups. Administration of loperamide plus ORT for the management of traveler's diarrhea, in cases in which subjects w ere encouraged to drink ad libitum, offered no benefit over administration of loperamide alone.