Johnson P C, Ericsson C D, DuPont H L, Morgan D R, Bitsura J A, Wood L V
JAMA. 1986 Feb 14;255(6):757-60.
Loperamide hydrochloride was compared with bismuth subsalicylate for the treatment of acute nondysenteric travelers' diarrhea in 219 students visiting seven countries in Latin America. Subjects whose condition was not improved with therapy could elect to take trimethoprim-sulfamethoxazole. Persons receiving loperamide passed fewer unformed stools when compared with the bismuth subsalicylate group during the first four hours of therapy, from four to 24 hours, and from 24 to 48 hours after therapy was initiated. Among subjects with disease due to enterotoxigenic Escherichia coli, Shigella sp, other pathogens, and unknown agents, fewer unformed stools were passed by the loperamide-treated subjects than the bismuth subsalicylate-treated subjects for all time periods studied. No significant prolongation of disease was seen in subjects with shigellosis treated with loperamide. Eight of the loperamide-treated subjects experienced constipation compared with one in the bismuth subsalicylate-treated group; otherwise, there was no difference in minor side effects experienced between both treatment groups. We conclude that loperamide is a safe and effective alternative to bismuth subsalicylate for the treatment of nondysenteric travelers' diarrhea.
在219名前往拉丁美洲七个国家的学生中，对盐酸洛哌丁胺和次水杨酸铋治疗急性非痢疾性旅行者腹泻进行了比较。经治疗病情未改善的受试者可选择服用甲氧苄啶 - 磺胺甲恶唑。与次水杨酸铋组相比，接受洛哌丁胺治疗的人在治疗开始后的前四个小时、4至24小时以及24至48小时内排出的不成形粪便较少。在由产肠毒素大肠杆菌、志贺氏菌属、其他病原体和不明病原体引起疾病的受试者中，在所有研究时间段内，接受洛哌丁胺治疗的受试者排出的不成形粪便都比接受次水杨酸铋治疗的受试者少。用洛哌丁胺治疗的志贺氏菌病患者未出现疾病明显延长的情况。接受洛哌丁胺治疗的受试者中有8人出现便秘，而接受次水杨酸铋治疗的组中有1人出现便秘；除此之外，两个治疗组在轻微副作用方面没有差异。我们得出结论，洛哌丁胺是治疗非痢疾性旅行者腹泻的一种安全有效的替代次水杨酸铋的药物。
