Department of Internal Medicine, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20889, USA.
Enteric Diseases Department, Naval Medical Research Center, 503 Robert Grant Ave., Silver Spring, MD 20910, USA.
Travel Med Infect Dis. 2014 Jul-Aug;12(4):360-3. doi: 10.1016/j.tmaid.2013.12.007. Epub 2014 Jan 21.
This study assessed the efficacy of education and self-treatment with loperamide on diarrhea morbidity and healthcare utilization in a deployed military setting.
In this prospective, controlled study, volunteers from military personnel deployed to Incirlik Air Base received either travelers' diarrhea education (non-loperamide group) or education plus a supply of loperamide (loperamide group). Volunteers were surveyed to determine frequency and outcomes of diarrheal illness.
109 deployed personnel were enrolled with 48 assigned to the loperamide group, and 61 to the non-loperamide group. Overall, 41 (38%) service members had at least one diarrheal episode. Only 10 (9%) service members sought treatment from a healthcare provider and the distribution was similar in both groups. Loperamide use for self-treatment was more common in the loperamide group (85%) vs. (57%), [p = 0.02]) but use of antibiotics was similar in both groups (loperamide (30%) vs. non-loperamide (20%).
Provision of loperamide and education did not significantly affect healthcare utilization or antibiotic use to manage diarrheal episodes, when compared to education alone. Further prospective studies will either need a very large patient population to power them or should use other primary end points such a functional assessment in addition to seeking care.
本研究评估了在部署的军事环境中，洛哌丁胺教育和自我治疗对腹泻发病率和医疗保健利用的疗效。
在这项前瞻性、对照研究中，从部署到因吉尔利克空军基地的军事人员中招募志愿者，他们接受旅行者腹泻教育（非洛哌丁胺组）或教育加洛哌丁胺供应（洛哌丁胺组）。调查志愿者以确定腹泻病的频率和结果。
共纳入 109 名部署人员，其中 48 名分配到洛哌丁胺组，61 名分配到非洛哌丁胺组。总体而言，41 名（38%）服务成员至少有一次腹泻发作。只有 10 名（9%）服务成员向医疗保健提供者寻求治疗，两组的分布相似。洛哌丁胺自我治疗的使用率在洛哌丁胺组（85%）高于非洛哌丁胺组（57%），[p=0.02]），但两组抗生素的使用相似（洛哌丁胺（30%）与非洛哌丁胺（20%）。
与单独教育相比，提供洛哌丁胺和教育并没有显著影响腹泻发作的医疗保健利用或抗生素使用。进一步的前瞻性研究要么需要一个非常大的患者人群来为他们提供动力，要么应该使用其他主要终点，如除寻求护理外的功能评估。
