Ericsson CD, DuPont HL, Mathewson JJ
Center for Infectious Diseases, The University of Texas-Houston Health Science Center, Houston, Texas.
J Travel Med. 1997 Mar 1;4(1):3-7. doi: 10.1111/j.1708-8305.1997.tb00765.x.
Background: Although the use of the antimicrobial, trimethoprim-sulfamethoxazole, in combination with the antisecretory and antimotility agent, loperamide, has been shown to be efficacious in the treatment of traveler's diarrhea, the use of fluoroquinolone antimicrobials in combination with loperamide has less support in the literature. The present study was designed to compare the efficacy of ofloxacin versus ofloxacin plus loperamide in the treatment of acute traveler's diarrhea. Method: This prospective, randomized, evaluator-blinded treatment trial was conducted in Guadalajara, Mexico, during the summers of 1992-1994. Adults newly arrived in Mexico from the United States who developed acute diarrhea of less than 2 weeks' duration were randomized to receive orally either: A) ofloxacin, 400 mg once; B) ofloxacin, 200 mg twice a day for six doses; or C) ofloxacin, 400 mg once, plus loperamide, 4 mg once followed by 2 mg after each loose stool, not to exceed 16 mg per day, for 3 days. The duration of illness was the number of hours elapsed from the beginning of therapy to the passage of the last unformed stool. Results: Ofloxacin and loperamide were well tolerated. Combination therapy with single dose ofloxacin plus loperamide was significantly more efficacious in reducing the duration of diarrhea than single dose ofloxacin or ofloxacin given for 3 days (p <.00001). Furthermore, combination therapy was more efficacious when enterotoxigenic Escherichia coli (ETEC) was the pathogen (p <.01) or when no pathogen was isolated (p <.001). Sixty-three percent of subjects passed no further unformed stools after the initial doses of combination therapy, and 91% were well by the end of the first 24 hours. Conclusions: The combined use of a single dose of ofloxacin with loperamide is safe and more efficacious in the treatment of traveler's diarrhea than use of ofloxacin alone.
尽管已证明将抗菌药物甲氧苄啶 - 磺胺甲恶唑与抗分泌和抗动力药物洛哌丁胺联合使用对治疗旅行者腹泻有效，但氟喹诺酮类抗菌药物与洛哌丁胺联合使用在文献中的支持较少。本研究旨在比较氧氟沙星与氧氟沙星加洛哌丁胺治疗急性旅行者腹泻的疗效。方法：这项前瞻性、随机、评估者盲法治疗试验于1992 - 1994年夏季在墨西哥瓜达拉哈拉进行。从美国新抵达墨西哥且发生持续时间少于2周的急性腹泻的成年人被随机分为口服以下药物：A）氧氟沙星400毫克，一次服用；B）氧氟沙星200毫克，每日两次，共六剂；或C）氧氟沙星400毫克，一次服用，加洛哌丁胺4毫克，一次服用，随后每次稀便后服用2毫克，每日不超过16毫克，共服用3天。疾病持续时间是从治疗开始到最后一次不成形粪便排出所经过的小时数。结果：氧氟沙星和洛哌丁胺耐受性良好。单剂量氧氟沙星加洛哌丁胺的联合治疗在缩短腹泻持续时间方面比单剂量氧氟沙星或服用3天的氧氟沙星显著更有效（p <.00001）。此外，当产肠毒素大肠杆菌（ETEC）为病原体时（p <.01）或未分离出病原体时（p <.001），联合治疗更有效。63%的受试者在初始联合治疗剂量后未再排出不成形粪便，91%的受试者在最初24小时结束时病情好转。结论：单剂量氧氟沙星与洛哌丁胺联合使用在治疗旅行者腹泻方面比单独使用氧氟沙星更安全、更有效。
