An independent review of the effects of treating cholera with antimicrobial drugs was conducted by researchers from the Cochrane Infectious Diseases Group, co-ordinated through the editorial base in LSTM. The results are published in The Cochrane Library. Cholera is an acute watery diarrhoea caused by infection with the bacterium Vibrio cholerae, which can cause rapid dehydration and death. Effective treatment requires early diagnosis and rehydration using oral rehydration salts or intravenous fluids. This review looked at the effects of adding antimicrobial drugs to this treatment. Thirty-nine randomized and quasi-randomized controlled clinical trials were included in the review, with a combined total of 4623 participants, both adults and children. Overall the researchers found that antimicrobial therapy shortened the average duration of diarrhoea by about a day and a half when compared to placebo or no treatment. Antimicrobial therapy also reduced the total stool volume by 50% and reduced the amount of rehydration fluids required by 40%, and shortened the duration of fecal extraction of vibrios bacteria by almost three days. There was substantial variation between trials in the size of these benefits, probably due to differences in the antibiotic used, the trial methods (particularly effective randomization), and the timing of outcome assessment. However the benefits of antibiotics were seen both in trials recruiting only patients with severe dehydration and in those recruiting patients with mixed levels of dehydration. In direct head-to-head comparisons, researchers found that there were no obvious differences detected in diarrhoea duration or stool volume for tetracycline compared to doxycycline or tetracycline compared to ciprofloxacin or norfloxacin. However, a higher number of studies looked at indirect comparisons and in those cases tetracycline appeared to have larger benefits than doxycycline, norfloxacin and trimethoprim-sulfamethoxazole, while single dose azithromycin shortened the duration of diarrhoea by over a day compared to ciprofloxacin and by half a day compared to erythromycin. Tetracycline was not compared with azithromycin. Ya'ara Leibovici-Weissman from Tel Aviv University said: "In treating cholera a quick and accurate diagnosis remains key, but it is clear from the results that antimicrobials result in substantial improvements in clinical and microbiological outcomes, with similar effects observed in severely and non-severely ill patients. Our results also point to the likelihood that azithromycin and tetracycline may have some advantages over other antibiotics." Source: Eurekalert << Tang Prize for Cancer Quest Awarded to US, Japanese Immunol... Hip Streets the Meeting Place for World Cup's Winners, Lose... >> Recommended Reading Cholera Cholera is an infection of the small intestine and is caused by the bacterium Vibrio cholerae. READ MORE Health Effects of Global Warming Greenhouse effect causes excessive heat to build up in the earth's atmosphere causing global warming and affects the environment and health. READ MORE Study Explains How Cholera-causing Bacteria Respond to Pressure In non-industrialized parts of the world today cholera remains common. READ MORE Amoebic Dysentery Amoebic dysentery or amoebiasis is an infection of the intestine that causes diarrhoea most frequently along with other causes. READ MORE Drug Toxicity Drug toxicity is an adverse reaction of the body towards a drug that results as a side effect of a drug, reaction to a drug or drug abuse. READ MORE Drugs Banned in India Several drugs are either banned or withdrawn after introduction in the market. READ MORE Food Preservatives - How Safe Are They? Food preservatives are basically antimicrobials or anti-oxidants that help preserve food by destroying the microbes and stopping decomposition of food products. READ MORE Most Popular on Medindia Fongitar (Zinc Pyrithionone) Daily Calorie Requirements Find a Hospital More News on: Drug ToxicityCholeraWater Borne DiseasesAmoebic DysenteryDrugs Banned in IndiaFood Preservatives - How Safe Are They?