The use of oral replacement solutions in the treatment of choleraand other severe diarrhoeal disorders.

Despite the progress that has been made in the treatment of cholera, mortality rates from this disease remain high in rural areas where intravenous fluids are not readily available. The authors have therefore conducted controlled studies into the efficacy of a simpler form of maintenance therapy-the administration of glucose-containing electrolyte solutions by mouth. The results obtained from the study of 51 adult patients (36 with cholera and 15 with severe non-cholera diarrhoea) indicate that oral fluids are adequate for maintenance therapy in cholera and severe diarrhoeal disease, and that there is no significant increase in the duration of diarrhoea or in the stool volume in patients receiving such therapy.The addition of a non-specific adsorbent, charcoal, to the fluid led to a significant increase in the volume of diarrhoeal stools and to prolongation of vibrio excretion; its use is therefore not recommended. The use of oral replacement solutions should result in improvement of cholera treatment of adults in rural areas and in a reduction in the cost of treatment.