Treatment for eradicating cholera in children

Single-dose ciprofloxacin achieves clinical outcomes similar to, or better than with 12-dose erythromycin, but is less effective in eradicating V cholerae from stool in children, finds this week's issue of The Lancet.

Single-dose ciprofloxacin is effective for the treatment of severe cholera in adults.

Dr Debasish Saha and colleagues conducted a randomized, open label, controlled trial in 180 children age 2 to 15 years with V cholerae.

The team assessed whether single-dose ciprofloxacin would be as effective as 3-day, 12-dose erythromycin in achieving clinical cure in children with severe cholera.

Of the patients incuded, 90 received either a single 20 mg/kg dose of ciprofloxacin.

Treamtent was successful in 60% of children treated with ciprofloxacin

The Lancet

A further 90 patients received 12.5 mg/kg of erythromycin every 6 h for 3 days, and remained in hospital for 5 days.

The primary outcome was clinical success of treatment, defined as cessation of watery stools within 48 h of start of drug treatment.

The researchers reported that 162 children completed the study, and that analysis was done per protocol.

Treatment was clinically successful in 60% of children treated with ciprofloxacin and in 55% of those treated with erythromycin.

The team found that children receiving ciprofloxacin vomited less often to, had fewer stools, and less stool volume than those receiving erythromycin.

In addition, the researchers noted that bacteriological failure was more common in ciprofloxacin-treated patients than erythromycin-treated patients.

Dr Saha's team concludes, “Single-dose ciprofloxacin achieves clinical outcomes similar to, or better than, those achieved with 12-dose erythromycin treatment in childhood cholera, but is less effective in eradicating V cholerae from stool.”