TY - JOUR
T1 - Use of azithromycin for the treatment of campylobacter enteritis in travelers to Thailand, an area where ciprofloxacin resistance is prevalent
AU - Kuschner, Robert A.
AU - Trofa, Andrew F.
AU - Thomas, Richard J.
AU - Hoge, Charles W.
AU - Pitarangsi, Chittima
AU - Amato, Steven
AU - Olafson, Raymond P.
AU - Echeverria, Peter
AU - Sadoff, Jerald C.
AU - Taylor, David N.
N1 - Funding Information:
Received 4 January 1995; revised 21 March 1995. The views expressed in this paper are those ofthe authors and not necessarily those of the U.S. Departments of Defense, Army, or Navy. This study was approved by the Human Subjects Research Review Board of the Office of the U.S. Army Surgeon General. Written informed consent was obtained from each participant prior to enrollment in the study. Financial support: This study was supported in part by Miles Pharmaceuticals (West Haven, Connecticut). Reprints or correspondence: Dr. Robert Kuschner, Department of Clinical Trials, Division of Communicable Diseases and Immunology, Walter Reed Army Institute of Research, Washington, D.C. 20307-5100.
PY - 1995/9
Y1 - 1995/9
N2 - We evaluated the use of azithromycin (500 mg) or ciprofloxacin (500 mg) daily for 3 days forthe treatment of acute diarrhea among United States military personnel in Thailand. Stool cultures were obtained and symptoms were recorded on study days 0, 1, 2, 3, and 10. Campylobacter species were the most common pathogen isolated (44 isolates from 42 patients). All Campylobacter isolates were susceptible to azithromycin; 22 were resistant to ciprofloxacin. Among the 42 patients with campylobacterinfection, there were 2 clinical and 6 bacteriologic treatment failures in the ciprofloxacin group and no treatment failures in the azithromycin group (P =.021 for bacteriologic failures). Overall, azithromycin was as effective as ciprofloxacin in decreasing the duration of illness (36.9 hours vs. 38.2 hours, respectively) and the number of stools (6.4 vs. 7.8, respectively). Among those not infectedwith Campylobacter species (n = 30), the duration of illness was 32.9 hours vs. 20.7 hours (P =.03) for the azithromycin and ciprofloxacin groups, respectively. Azithromycin is superior to ciprofloxacin in decreasing the excretion of Campylobacter species and as effective as ciprofloxacin in shortening the duration of illness. Azithromycin therapy may be an effective alternative to ciprofloxacin therapy in areas where ciprofloxacin-resistant Campylobacter species are prevalent.
AB - We evaluated the use of azithromycin (500 mg) or ciprofloxacin (500 mg) daily for 3 days forthe treatment of acute diarrhea among United States military personnel in Thailand. Stool cultures were obtained and symptoms were recorded on study days 0, 1, 2, 3, and 10. Campylobacter species were the most common pathogen isolated (44 isolates from 42 patients). All Campylobacter isolates were susceptible to azithromycin; 22 were resistant to ciprofloxacin. Among the 42 patients with campylobacterinfection, there were 2 clinical and 6 bacteriologic treatment failures in the ciprofloxacin group and no treatment failures in the azithromycin group (P =.021 for bacteriologic failures). Overall, azithromycin was as effective as ciprofloxacin in decreasing the duration of illness (36.9 hours vs. 38.2 hours, respectively) and the number of stools (6.4 vs. 7.8, respectively). Among those not infectedwith Campylobacter species (n = 30), the duration of illness was 32.9 hours vs. 20.7 hours (P =.03) for the azithromycin and ciprofloxacin groups, respectively. Azithromycin is superior to ciprofloxacin in decreasing the excretion of Campylobacter species and as effective as ciprofloxacin in shortening the duration of illness. Azithromycin therapy may be an effective alternative to ciprofloxacin therapy in areas where ciprofloxacin-resistant Campylobacter species are prevalent.
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U2 - 10.1093/clinids/21.3.536
DO - 10.1093/clinids/21.3.536
M3 - Article
C2 - 8527539
AN - SCOPUS:0029144059
SN - 1058-4838
VL - 21
SP - 536
EP - 541
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 3
ER -