ERYTHROMYCIN AND TRIMETHOPRIM-SULFAMETHOXAZOLE IN THE TREATMENT OF CHOLERA IN CHILDREN

To evaluate the efficacy of erythromycin and trimethoprim-sulphamethox azole (TMP-SMX) in the treatment of cholera in children aged 1-8 years , a randomised clinical trial was conducted at a diarrhoea treatment c entre in Bangladesh from December 1991 to June 1992. Fifteen children received erythromycin, 50 mg/kg per day, in fear equally divided doses , 18 children received 10 mg/kg per day of trimethoprim and 50 mg/kg p er day of sulphamethoxazole in two equally divided doses (12 hourly) f or five days, and 15 children received no antibiotic; children in all three groups received intravenous cholera saline for severe dehydratio n and for mild to moderate dehydration, a rice-based oral rehydration solution, The mean stool volumes in mL/kg body weight in the two treat ment groups were less than that of the control group, and there were n o significant differences in stool volume among the two treatment grou ps. However, 67% of the children in the erythromycin group and 82% in the TMP-SMX group recovered within 72 hours compared to 33% in the con trol group (p<0.01), Similarly, the bacteriological cures were 80% in the erythromycin group and 83% in the TMP-SMX group compared to only 2 7% in the control group (p<0.001). These results confirm that both ery thromycin and trimethoprim-sulphamethoxazole are effective antimicrobi als in the treatment of cholera, These drugs are of value specially in younger children in wham tetracycline is contraindicated or when the infecting Vibrio cholerae are resistant to tetracycline.