tetracycline and Cholera

Non-O1/non-O139

Topics: Anti-Bacterial Agents; Chloramphenicol; Cholera; Ciprofloxacin; Drug Resistance, Bacterial; Erythromycin; Gentamicins; Humans; Kanamycin; Microbial Sensitivity Tests; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination; Vibrio cholerae non-O1

Topics: Carrier State; Cholera; Doxycycline; Humans; Sulfadoxine; Tetracycline; Treatment Failure

Topics: Americas; Cholera; Clinical Protocols; Disease Outbreaks; Doxycycline; Fluid Therapy; Humans; Infusions, Intravenous; Tetracycline; Travel

Topics: Anti-Infective Agents, Urinary; Antidiarrheals; Chloramphenicol; Chlorpromazine; Cholera; Diarrhea; Drug Combinations; Enterotoxins; Escherichia coli; Escherichia coli Infections; Fluid Therapy; Furazolidone; Humans; Sulfamethoxazole; Tetracycline; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Water-Electrolyte Balance

Topics: Animals; Anti-Bacterial Agents; Chloramphenicol; Cholera; Drug Resistance, Microbial; Ecology; Humans; L Forms; Philippines; R Factors; Rabbits; Streptomycin; Tetracycline; Vibrio cholerae

Topics: Acid-Base Equilibrium; Acute Disease; Age Factors; Bicarbonates; Body Temperature; Child; Child, Preschool; Cholera; Citrates; Coma; Feces; Furazolidone; Glucose; Humans; Hypertonic Solutions; Infusions, Parenteral; Injections, Intraperitoneal; Injections, Intravenous; Potassium; Seizures; Sodium; Tetracycline; Water-Electrolyte Balance

Topics: Africa, Western; Animals; Bicarbonates; Child; Chlorides; Cholera; Diarrhea; Dogs; Enterotoxins; Europe; Feces; Glucose; Humans; Intestinal Absorption; Intestinal Diseases; Intestinal Mucosa; Isotonic Solutions; Potassium; Sodium; Tetracycline; Water-Electrolyte Balance

Topics: Asia, Southeastern; Asia, Western; Carrier State; Child, Preschool; Cholera; Cholera Vaccines; Glucose; Humans; India; Indonesia; Sodium Chloride; Tetracycline; Water-Electrolyte Balance

Topics: Anti-Bacterial Agents; Carrier State; Chloramphenicol; Cholera; Clioquinol; Disease Outbreaks; Drug Resistance, Microbial; Erythromycin; Humans; Kanamycin; Nitrofurans; Paromomycin; Streptomycin; Tetracycline; Vibrio

Topics: Administration, Oral; Adult; Bicarbonates; Blood Proteins; Child; Cholera; Feces; Glucose; Humans; Infusions, Parenteral; Potassium; Sodium Chloride; Tetracycline

Topics: Ampicillin; Anti-Bacterial Agents; Benzoates; Bicarbonates; Blood Transfusion; Chloral Hydrate; Chloramphenicol; Cholera; Electrocardiography; Epinephrine; Erythromycin; Glucose; Humans; Hypertonic Solutions; Lactates; Magnesium Sulfate; Mobile Health Units; Norepinephrine; Oleandomycin; Potassium; Potassium Chloride; Promethazine; Sodium Chloride; Strophanthins; Tetracycline; Theophylline; Time Factors; Water-Electrolyte Balance

Topics: Animals; Antibody Formation; Antigens; Cholera; Cholera Vaccines; Disease Vectors; Humans; Immunization; India; Mice; Pakistan; Philippines; Rabbits; Rats; Serologic Tests; Streptomycin; Tetracycline

Topics: Child; Cholera; Dehydration; Humans; Infant; Potassium; Sodium Chloride; Tetracycline; Water-Electrolyte Balance

Topics: Animals; Anti-Bacterial Agents; Bacteriophages; Chloramphenicol; Cholera; Guinea Pigs; Immunization, Passive; Mice; Plant Extracts; Plants, Medicinal; Rabbits; Tetracycline; Transferases

This study examined the comparative efficacies of rice-based oral rehydration solution (R-ORS) and glucose-based oral rehydration solution (G-ORS) in the management of severe cholera due to Vibrio cholerae O139 Bengal that causes epidemic cholera in many developing countries. Stool culture-proved adult male patients with severe cholera due to V. cholerae O139 Bengal were randomly assigned in a 1:1 ratio to receive either R-ORS or G-ORS after their initial rehydration with intravenous (i.v.) fluid and subsequently four hours of observation. They also received the usual hospital diet and tetracycline capsules (500 mg 6 hourly for three days) immediately after their enrollment in the study. The primary outcomes for observation were stool output during the first 24 hours after intervention and treatment failure as measured by the incidence of re-institution of i.v. fluid after initiation of trial therapy and duration of diarrhoea. Of 113 patients finally included in the study, 57 received R-ORS and 56 G-ORS. The admission characteristics of the two treatment groups were comparable. No significant differences in the first 24 hours of median (inter-quartile range) stool output [179 (67-206) g/kg in R-ORS group vs 193 (80-237) g/kg in G-ORS group; p = 0.52], incidences of unscheduled i.v. fluid requirement [21% (12/57) in R-ORS group vs 25% (14/56) in G-ORS group; p = 0.78], and median (inter-quartile range) duration of diarrhoea [32 (24-48) hours in R-ORS group vs 32 (24-56) hours in G-ORS group; p = 0.64] were observed. It is concluded that rice-based ORS is effective but not superior to standard glucose-based ORS in the management of adult males with severe cholera due to V. cholerae O139 Bengal.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Cholera; Feces; Fluid Therapy; Glucose; Humans; Male; Middle Aged; Oryza; Tetracycline; Treatment Outcome; Vibrio cholerae O139

Vibrio cholerae O139 synonym Bengal, recognized in 1993, is the second member in the list of about 200 serogroups of V. cholerae with epidemic and pandemic potential. Although replacement of fluids and electrolytes remains the cornerstone in the management of cholera, antimicrobial therapy can significantly shorten the duration of diarrhoea, and reduce stool volume and requirements ofrehydration fluids. The role of antimicrobial therapy on the natural course of the disease caused by this relatively new pathogen has not been systematically assessed. A randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the efficacy of tetracycline in the treatment of adults with severe cholera due to V. cholerae O139 Bengal. Forty-three adult males with severe cholera were randomly allocated to receive either 500 mg of tetracycline (n=21) or placebo (n=22) for three consecutive days. Demographic and clinical characteristics of these patients on admission were comparable. Tetracycline therapy was associated with significantly reduced total median (inter-quartile range) stool volume [216.48 (90.18-325.22) mL/kg vs 334.25 (215.12-537.64) mL/kg; p=0.001], higher rates of clinical cure (81% vs 27%; p<0.001), and shorter median (inter-quartile range) duration of diarrhoea [32 (24-48) hours vs 80 (48-104) hours; p<0.001]. The mean +/- (SD) requirement of intravenous fluid was not significantly different between the two groups [146.42 +/- 42.12 mL/kg vs 150.44 +/- 27.21 mL/kg; p=0.70]. The median (inter-quartile range) duration of faecal excretion of V. cholerae O139 was significantly shorter in the tetracycline group than the placebo group [1(1-2) day vs 5 (3-6) days; p<0.001]. The results of the study indicate that tetracycline therapy is clinically useful in the treatment of severe cholera due to V. cholerae O139 Bengal.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Cholera; Dehydration; Diarrhea; Double-Blind Method; Fluid Therapy; Humans; Male; Middle Aged; Tetracycline; Time Factors; Vibrio cholerae

In a randomized controlled clinical trial, the efficacy of a low-sodium low-glucose oral rehydration solution (ORS) and a low-sodium rice-based ORS was compared with standard WHO glucose ORS in the treatment of severe cholera in children aged 2-10y. In total, 120 children were evaluated for the study, of whom 58 patients were positive for Vibrio cholerae and were included in the study. Of these 58 cases, 19 received rice-based hypo-osmolar ORS, 20 received WHO-ORS and 19 received glucose-based hypo-osmolar ORS. The clinical characteristics (age, preadmission duration of diarrhoea, frequency of stool before admission, incidence of vomiting, body weight and volume of initial fluid requirement) were comparable in the three treatment groups. All patients received tetracycline in a dose of 50 mg/kg/d of body weight in 4 divided doses for 3 d.. Patients who received rice-based hypo-osmolar ORS had subsequently reduced (p < 0.05) stool output, ORS consumption and diarrhoea duration than the patients who received either WHO-ORS or glucose-based hypo-osmolar ORS.

Topics: Child; Child, Preschool; Cholera; Female; Fluid Therapy; Glucose; Humans; Male; Oryza; Osmolar Concentration; Phytotherapy; Tetracycline; Vibrio cholerae; World Health Organization

Antibiotic treatment appears to shorten the duration of diarrhea and eradicate Vibrio cholerae. The objective of this study was to compare the efficacy of tetracycline with norfloxacin therapy in patients (adults and children) with acute severe watery diarrhea caused by VC 01 and VC 0139. Patients (adults and children) with acute severe watery diarrhea admitted to Bamrasnaradura Infectious Disease Hospital, Thailand were randomized to receive either tetracycline (500 mg qid in adults and 12.5 mg/kg qid in children) or norfloxacin (400 mg bid in adults and 7.5 mg/kg bid in children) for 3 days each. The duration of diarrhea and the fecal shedding were comparable between two groups. Thirteen cases were treated with tetracycline and twelve cases with norfloxacin. The results showed the mean duration of diarrhea in tetracycline-treated and norfloxacin-treated groups were 1.31 and 1.25 days, respectively. The mean fecal shedding in tetracycline-treated and norfloxacin-treated group were 1.38 and 1.33 days, respectively. However, there were no statistically significant differences between two groups of both comparisons (p > 0.05). All isolates (VC 01 and VC 0139) in this study were susceptible to both antibiotics. Tetracycline therapy is as good as norfloxacin therapy for quick recovery and time for bacterial eradication in patients with acute severe watery diarrhea caused by Vibrio cholerae. Children aged less than 8 years should not use tetracycline therapy because of its toxic effects.

Topics: Adolescent; Adult; Age Factors; Aged; Anti-Bacterial Agents; Anti-Infective Agents; Child; Child, Preschool; Cholera; Diarrhea; Female; Humans; Infant; Male; Middle Aged; Norfloxacin; Tetracycline; Vibrio cholerae

The purpose of the study reported here was to compare the bactericidal effectiveness of tetracycline and co-trimoxazole (a combination of sulfamethoxazole and trimethoprim) in treating cholera. The study, an open-ended random trial using adult patients with cholera cases confirmed by stool culture, was carried out in March 1993 at the Cholera Treatment Unit (CTU) of the Hospital de Apoyo Departmental María Auxiliadora in Lima, Peru. A total of 107 subjects were divided into two groups (A and B). The 50 in Group A received 500 mg of tetracycline orally every 6 hours for 3 days; the 57 in Group B received co-trimoxazole (160 mg of trimethoprim and 800 mg of sulfamethoxazole) orally every 12 hours for 3 days. The two groups were comparable in terms of age, sex, duration of symptoms prior to hospital admission, time at which antibiotic treatment was initiated, and clinical evolution. Control stool cultures of specimens obtained after treatment showed Vibrio cholerae O-1 present in 2% of the Group A and 12.3% of the Group B patients, and also showed V. cholerae non-O-1 present in 2% of the Group A patients and 3.5% of the Group B patients. Overall, it was concluded that both therapeutic treatment regimens were effective and that the strains of V. cholerae observed in the southern sector of the city of Lima were still susceptible to both antibiotics.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Cholera; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Prospective Studies; Single-Blind Method; Tetracycline; Tetracycline Resistance; Trimethoprim, Sulfamethoxazole Drug Combination

We conducted a randomized, double-blind clinical trial to compare ciprofloxacin (250 mg once a day for 3 days) with tetracycline (500 mg four times a day for 3 days) in terms of efficacy and safety in the treatment of moderate-to-severe cholera in Peruvian adults. The baseline characteristics of the groups were similar. A total of 202 patients (102 in the tetracycline group and 100 in the ciprofloxacin group) were included in the efficacy analysis. The clinical and bacteriologic efficacies of the two regimens were similar. The study drugs were well tolerated. We conclude that ciprofloxacin given once a day is as effective as the standard tetracycline regimen for the treatment of cholera in adults. The ciprofloxacin regimen may represent an alternative to the standard treatment in areas where Vibrio cholerae O1 strains that are resistant to commonly used antimicrobials are prevalent.

Topics: Administration, Oral; Adolescent; Adult; Aged; Cholera; Ciprofloxacin; Double-Blind Method; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Peru; Tetracycline; Treatment Outcome

To compare the efficacy of a single dose of doxycycline (200 or 300 mg) with the standard multiple doses of tetracycline in patients with cholera.. Randomised double blind controlled trial. Patients were given a single 200 mg dose of doxycycline, a single 300 mg dose of doxycycline, or multiple doses of tetracycline (500 mg, six hourly intervals).. Hospital in Bangladesh treating diarrhoea.. 261 Patients aged over 15 admitted to the hospital with severe dehydration due to acute watery diarrhoea associated with Vibrio cholerae. All vibrios isolated from the stools and rectal swabs of patients, including those patients with prolonged excretion of vibrios, were sensitive to tetracycline. The stools of all patients at admission were negative for shigella and salmonella.. All patients received rapid intravenous acetate solution for the first four hours after admission to hospital. They were then entered in the study and randomised. Oral rehydration was started immediately after the intravenous treatment. If signs of severe dehydration reappeared during oral treatment patients were given rapid intravenous acetate solution until dehydration was fully corrected.. Stool output in first 24 hours and till diarrhoea stopped, total intake of oral rehydration fluid, duration of diarrhoea, and excretion of vibrio after receiving antibiotic treatment.. The median stool outputs during the first 24 hours (275 ml/kg body weight) and till diarrhoea stopped (296 ml/kg body weight) were significantly higher in patients receiving 200 mg doxycycline as a single dose than in patients receiving either standard tetracycline (242 ml/kg body weight and 254 ml/kg body weight) or 300 mg doxycycline (226 ml/kg body weight and 255 ml/kg body weight). Similarly, median consumption of oral rehydration solution (18.45 l) was significantly higher in patients receiving 200 mg doxycycline than in patients receiving either 300 mg doxycycline (16.10 l) or standard tetracycline (14.80 l). Almost equal numbers of patients in each group required unscheduled intravenous acetate solution to correct dehydration during antibiotic treatment. Patients treated with doxycycline (low or high dose), however, had more prolonged excretion of bacteria.. A single 300 mg dose of doxycycline is as effective as the standard multiple dose tetracycline treatment for cholera in terms of stool output, duration of diarrhoea, vomiting, and requirement for oral rehydration solution.

Topics: Adolescent; Adult; Cholera; Diarrhea; Double-Blind Method; Doxycycline; Female; Fluid Therapy; Humans; Male; Middle Aged; Randomized Controlled Trials as Topic; Tetracycline; Time Factors

To evaluate single doses of 400 mg of furazolidone and 1 g of tetracycline given orally to patients with diarrhea due to Vibrio cholerae, we studied 87 adults in a randomized, double-blind, placebo-controlled trial. All patients received intravenous fluids for rehydration and no other drugs. The total volumes of stool (mean +/- standard deviation) during a 6-day period after treatment were significantly smaller in the tetracycline group (10.5 +/- 8.6 liters) than in the furazolidone group (20.9 +/- 15.9 liters) and the placebo group (19.1 +/- 10.5 liters) (P less than 0.01). The duration of diarrhea and volumes of intravenous fluids were also significantly reduced in the tetracycline group (P less than 0.05). However, there were no differences between the furazolidone and the placebo groups with regard to stool volume, intravenous fluid, and duration of diarrhea. Within 48 h of treatment, tetracycline significantly reduced the number of patients with positive stool cultures for V. cholerae (37%) compared with furazolidone treatment (96%) and the placebo (97%) (P less than 0.001). Although the tetracycline group had a significantly higher incidence (61%) of bacteriologic relapse (negative stool cultures on days 2 and 3, followed by positive cultures afterward) compared with that in the furazolidone group (40%) and the placebo group (33%), this was not associated with clinical relapse. There were no differences between the furazolidone and placebo groups with regard to any of the bacteriologic responses examined. These data indicate that a single dose of 1 g of tetracycline is effective in the treatment of cholera, but it is asymptomatic bacteriologic relapse. A single dose of 400 mg of furazolidone is not therapeutically effective in cholera.

Topics: Adult; Cholera; Diarrhea; Double-Blind Method; Feces; Furazolidone; Humans; Randomized Controlled Trials as Topic; Tetracycline

A randomised clinical trial was carried out to explore the efficacy of single dose tetracycline therapy in cholera. One hundred and eighteen adult patients were assigned to receive either tetracycline in a single 1 g, or a single 2 g dose, or tetracycline 500 mg every six hours four times, or no antibiotics as controls. The means of total liquid stool volumes after treatment were lower in the single 1 g dose group (168.0 +/- 20.9 ml/kg), in single 2 g dose group (229.5 +/- 45.6 ml/kg), and multiple dose group (214 +/- 28.5 ml/kg), than in the control group (499.1 +/- 56.5 ml/kg) (p less than 0.05). Similarly, the means of durations of diarrhoea and intravenous fluid requirements were significantly lower in the single dose and multiple dose tetracycline groups, than in the controls (p less than 0.05). The mean durations of excretion of Vibrio cholerae were significantly shortened from 3.9 +/- 0.2 days in the control group to 1.9 +/- 0.2 days in single 1 g dose, to 2.2 +/- 0.4 days in single 2 g dose and 1.3 +/- 0.1 days in multiple dose groups, respectively (p less than 0.05). Three patients in the single 1 g dose group and two patients in single 2 g dose group had clinical relapses with excretion of V cholerae during the relapses, but this was not significantly more frequent than that in the multiple dose group (p greater than 0.05). These findings suggest that although multiple dose tetracycline therapy remains the best choice, a single dose of either 1 g or 2 g tetracycline appears to be a reasonable alternative for the treatment of cholera as an adjunct to rehydration therapy.

Topics: Adult; Cholera; Clinical Trials as Topic; Diarrhea; Dose-Response Relationship, Drug; Drug Administration Schedule; Feces; Female; Humans; Male; Middle Aged; Random Allocation; Recurrence; Tetracycline; Vibrio cholerae

Topics: Adult; Berberine; Berberine Alkaloids; Cholera; Clinical Trials as Topic; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Male; Random Allocation; Tetracycline

To evaluate the antisecretory activity of berberine sulfate (BS), we studied 165 adult patients with acute diarrhea due to enterotoxigenic Escherichia coli (ETEC) and Vibrio cholerae in randomized controlled trials. In patients with ETEC diarrhea who received 400 mg of BS in a single oral dose, the mean stool volumes were significantly less than those of the controls during three consecutive 8-hr periods after treatment (P less than .05). At 24 hr after treatment, significantly more patients who were treated with BS and had ETEC diarrhea stopped having diarrhea as compared with the controls (42% vs 20%, P less than .05). In patients with cholera who received 400 mg of BS, the mean 8-hr stool volume during the second 8-hr period after treatment declined to 2.22 liters, which was significantly less than the 2.79 liters found in the controls (P less than .05). However, patients with cholera who received 1200 mg of BS plus tetracycline did not have significant reduction in stool output compared with patients who received tetracycline alone. No side effects of BS were noted. These results indicated that BS is an effective and safe antisecretory drug for ETEC diarrhea, whereas the activity against cholera is slight and not additive with tetracycline.

Topics: Adult; Bacterial Toxins; Berberine; Berberine Alkaloids; Cholera; Clinical Trials as Topic; Diarrhea; Drug Therapy, Combination; Enterotoxins; Escherichia coli; Escherichia coli Infections; Escherichia coli Proteins; Humans; Male; Random Allocation; Tetracycline

Four hundred adults presenting with acute watery diarrhoea were entered into a randomised, placebo controlled, double blind clinical trial of berberine, tetracycline, and tetracycline and berberine to study the antisecretory and vibriostatic effects of berberine. Of 185 patients with cholera, those given tetracycline or tetracycline and berberine had considerably reduced volume and frequency of diarrhoeal stools, duration of diarrhoea, and volumes of required intravenous and oral rehydration fluid. Berberine did not produce an antisecretory effect. Analysis by factorial design equations, however, showed a reduction in diarrhoeal stools by one litre and a reduction in cyclic adenosine monophosphate concentrations in stools by 77% in the groups given berberine. Considerably fewer patients given tetracycline or tetracycline and berberine excreted vibrios in stools after 24 hours than those given berberine alone. Neither tetracycline nor berberine had any benefit over placebo in 215 patients with non-cholera diarrhoea.

Topics: Acute Disease; Adult; Berberine; Berberine Alkaloids; Cholera; Clinical Trials as Topic; Diarrhea; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Male; Random Allocation; Tetracycline

Topics: Adult; Cholera; Furazolidone; Humans; Minocycline; Tetracycline; Tetracyclines

In 51 actively purging cholera patients the efficacy of doxycycline, a long-acting tetracycline, was compared with a placebo and tetracycline hydrochloride. Seventeen patients who were given doxycycline at the recommended dose of 2 mg/kg at the beginning of the study, at 12 h, and at the repeated dose once daily purged a mean volume of 5.1 liters of stool and received an average of 5.7 liters of intravenous fluid. Nineteen patients receiving the placebo purged 10.1 liters of stool and received 9.7 liters of fluid. Fifteen patients given tetracycline hydrochloride at 6-h intervals passed 4.8 liters of stool and received 5.5 liters of fluid. The durations of diarrhea calculated in 8-h periods were 3.5, 8.0, and 4.1 h in the respective groups receiving doxycycline, placebo, and tetracycline. The differences between the doxycycline and placebo treatments and the tetracycline and placebo treatments were statistically significant. Those receiving doxycycline became vibrio-free in about 3 days as compared with 2 days for those receiving tetracycline; the group given the placebo were vibrio positive for the duration of their hospitalization. The results show that in the treatment of cholera the administration of doxycycline once daily has effects equal to those when tetracycline is administered at 6-h intervals. This is a distinct advantage because it decreases the demand on nursing personnel in epidemics. Also, doxycycline may be safely administered in cases of suspected renal failure from prolonged shock in cholera.

Topics: Cholera; Clinical Trials as Topic; Doxycycline; Feces; Humans; Placebos; Tetracycline; Vibrio cholerae

The severity of diarrhea and nutritional status were measured in a prospective study of 97 patients hospitalized with cholera in Dacca, Bangladesh. Ninety-five percent of both adults and children were below their respective medians in weight as related to height; greater than 15% of each group showed second-degree protein-calorie malnutrition. Duration of diarrhea, but no volume of stool per hour, was prolonged by 30%-70% in those adults and children suffering from more severe malnutrition. The increased stool loss was unrelated to antibiotic usage, to presence of intestinal parasites, or to the refeeding diet given. It is suggested that the prolongation of diarrhea represents the continued effect of cholera toxin that is irreversibly bound to intestinal mucosal cells, the replacement of which would be retarded under conditions of poor nutrition.. This study investigates the severity of cholera as related to status of protein-calorie nutrition in both tetracycline-treated and non-antibiotic-treated male patients (n=97) at the Cholera Research Hospital in Dacca, Bangladesh during the cholera epidemic of October through December 1974. Stool and urine samples were analyzed. 54 of the patients were severely dehydrated (plasma specific gravity, 1.034) and 43 were moderately dehydrated (plasma specific gravity, 1.030-1.034). Results show that 95% of both adults and children patients were below their median in weight as related to height and that more than 15% of each group showed 2nd degree protein-calorie malnutrition. Prolongation of diarrhea was marked in all patients. 30 to 70% increase in duration of diarrhea was seen in patients with severe malnutrition. Increased stool loss was not associated with antibiotic usage, presence of intestinal parasites, or to refeeding diet given. The findings show that malnutrition enhances risk of infection and particularly of diarrheal illness, which in turn produces more profound malnutrition. Increased stool losses and prolonged diarrhea in malnourished patients may result in large increases in fluid, electrolyte and nursing needs.

Topics: Bangladesh; Body Height; Body Weight; Child; Child, Preschool; Cholera; Diarrhea; Humans; Infant; Intestinal Mucosa; Male; Protein-Energy Malnutrition; Tetracycline; Toxins, Biological; Vibrio cholerae

Doxycycline was compared with tetracycline in the treatment of cholera. Four types of treatment were compared: Group A was given 200 mg of doxycycline on admission and 100 mg on the second day; Group B was given 200 mg of doxycycline on admission only; Group C was given 300 mg of doxycycline on admission only; and Group D received 500 mg of tetracycline every 6 h for 48 h. Tetracycline showed a slight advantage in respect of duration of diarrhoea and vibrio excretion compared with doxycycline given as a single dose of 300 mg, but fluid intake and output were about the same in these two groups. The other two doxycycline treatment schedules did not compare well with tetracycline treatment.

Topics: Adolescent; Adult; Aged; Child; Cholera; Doxycycline; Drug Evaluation; Humans; Male; Middle Aged; Tetracycline

Topics: Adolescent; Adult; Age Factors; Antibody Formation; Bangladesh; Child; Child, Preschool; Cholera; Cholera Vaccines; Clinical Trials as Topic; Disease Outbreaks; Humans; Infant; Infant, Newborn; Placebos; Tetracycline; Time Factors

Topics: Adolescent; Adult; Aged; Child; Cholera; Clinical Trials as Topic; Costs and Cost Analysis; Diarrhea; Feces; Folic Acid Antagonists; Humans; Middle Aged; Placebos; Pyrimidines; Sulfadimethoxine; Sulfamethoxazole; Tetracycline; Vibrio

This study reports the use of bacteriophage prepared in the USSR in the treatment of cholera. Patients with acute cholera were rehydrated with a standard intravenous solution and were then given a bacteriophage preparation in addition to maintenance intravenous therapy. The titre of the phage preparations was between 10(8) and 10(9) pfu/ml. Bacteriophage was given by mouth (25 ml for adults and 20 ml for children) for 3 days; in addition, some patients were also given an intramuscular injection (20 ml) of phage on the first day in hospital. For comparison, other groups of patients were given a standard tetracycline regimen or a placebo preparation. Daily vibrio and phage counts were made on stool samples from all patients and the vibrio strains isolated from each patient were tested for sensitivity to the phage preparation.The criteria used to evaluate the various therapies were duration of diarrhoea, volume of stool, and duration of vibrio excretion.The results of the study demonstrate that, in the doses used, the therapeutic effect of bacteriophage, if any, was markedly inferior to that of tetracycline and that in the current state of our knowledge bacteriophage, as used in this study, has no place in the treatment of cholera.

Topics: Adolescent; Adult; Bacteriophages; Child; Cholera; Clinical Trials as Topic; Feces; Female; Humans; Male; Placebos; Tetracycline; Vibrio

A controlled field study of the treatment of cholera carriers is described. The households of cholera patients were assigned to two groups: one group received 2 doses of tetracycline daily for 3 days and the other received a placebo of multivitamins. From the second to the fifth day of follow-up, there was a significant decrease in the number of vibrio excretors in the treated group as compared with the placebo group. Soon after withdrawal of the drug, the number of excretors rose in the treated group and ultimately it was the same in both groups.

Topics: Adolescent; Adult; Carrier State; Child; Child, Preschool; Cholera; Clinical Trials as Topic; Disease Reservoirs; Humans; India; Infant; Placebos; Tetracycline

A comparison of tetracycline, chloramphenicol, and trimethoprim/sulphamethoxazole showed that all hasten the eradication of Vibrio cholerae from the stools of patients with cholera.A four-day period of tetracycline or trimethoprim/ sulphamethoxazole was adequate for eradicating V. cholerae from the stools of all patients, but three days, as suggested by the W.H.O. Expert Committee, was not. Four days of chloramphenicol therapy was sufficient for most patients, but a minority required up to seven days' therapy.Purging produced reappearance of V. cholerae in the stools of one-eighth of the patients who had had three successive daily negative stool cultures; such patients are a potential danger to the population.

Topics: Adult; Cathartics; Child; Chloramphenicol; Cholera; Clinical Trials as Topic; Feces; Folic Acid Antagonists; Humans; Placebos; Pyrimidines; Sulfamethoxazole; Tetracycline; Vibrio

Topics: Cholera; Clioquinol; Female; Humans; Male; Pakistan; Tetracycline

Topics: Adult; Cholera; Furazolidone; Humans; Male; Tetracycline

A controlled comparison of furazolidone and tetracycline in the treatment of cholera indicates that, in either dosage used, furazolidone reduced total stool volume by 50% and duration of diarrhoea by 40%. These results are comparable to those achieved with tetracycline, which was given in presently recommended dosage. Both furazolidone and tetracycline significantly reduced the rate of stool output within 18 to 24 hours of starting antibiotic treatment. Furazolidone was significantly less effective than tetracycline in rapidly and consistently terminating vibrio excretion. One convalescent carrier of cholera vibrios was identified among control patients; none was identified among patients treated with either tetracycline or furazolidone. All Vibrio cholerae strains tested were sensitive to tetracycline and furazolidone, but larger concentrations of the latter were required to achieve inhibition of growth. It is concluded that tetracycline remains the antibiotic of choice in cholera but that furazolidone would be a useful adjunct to cholera therapy when tetracycline is unobtainable or if strains of V. cholerae with clinically significant resistance to tetracycline should be encountered.

Topics: Adult; Cholera; Clinical Trials as Topic; Diarrhea; Feces; Furazolidone; Humans; Male; Middle Aged; Tetracycline; Time Factors; Vibrio

The evaluation of tetracycline as a chemoprophylactic agent for cholera is described. Families of cholera patients were divided into 4 groups by strict rotation. The first group received multivitamin preparations and served as the control. The second received 1.0 g of tetracycline, divided into 4 doses, daily for 5 days, the third received 1.0 g of tetracycline in a single dose daily for 5 days, and the fourth received a single dose of 1.0 g of tetracycline. All families were visited daily for 10 days, a rectal swab being taken from each family member on each occasion. Tetracycline given daily for 5 days, either in divided doses or in a single daily dose, was effective in preventing subsequent infection. A single dose of tetracycline was less effective. The indications for chemoprophylaxis in cholera are discussed.

Topics: Adolescent; Child; Child, Preschool; Cholera; Clinical Trials as Topic; Female; Humans; Infant; Infant, Newborn; Male; Pakistan; Placebos; Tetracycline

Intravenous replacement of the diarrhoeal fluid and electrolyte losses to restore a physiological state of hydration is well established as the basis for successful management of cholera patients. The use of oral tetracycline as an adjunct in reducing the volume and duration of diarrhoea, as well as eradicating the vibrio from the gastrointestinal tract, has been proven beneficial. An optimal dose schedule has not been established previously, and clinical or bacteriological relapses have been generally reported. Chloramphenicol and sulfaguanidine have also been mentioned as adjuncts. The present report shows that 3 g or 4 g of tetracycline in one of 3 dose schedules were predictably efficacious. Chloramphenicol, while of benefit, was not as effective and sulfaguanidine was of little benefit compared with the tetracycline regimens.

Topics: Adolescent; Adult; Chloramphenicol; Cholera; Clinical Trials as Topic; Humans; India; Male; Middle Aged; Sulfaguanidine; Tetracycline

Recent clinical trials having established the value of tetracycline as an adjunct to fluid and electrolyte replacement in cholera treatment, a controlled trial of antibiotic therapy was conducted in Dacca on 318 adults hospitalized for cholera. The effects of 4 antibiotics orally administered in varying dosage schedules were studied.Cholera therapy with tetracycline or chloramphenicol caused a highly significant reduction in the duration of diarrhoea and of positive culture, in stool volume, and in intravenous fluid requirement as compared with the results in controls who received intravenous fluid therapy only. Streptomycin was also effective, but to a lesser degree; paromomycin was of little value.The severity of dehydration on admission was significantly related to subsequent duration of diarrhoea regardless of whether antibiotics were given. Increasing age was associated with more prolonged purging in patients receiving antibiotics.Increasing the dose of tetracycline to 2 to 3 times that usually administered, or prolonging treatment from 2 to 4 days, did not enhance the therapeutic results. The effect of tetracycline was apparent within a few hours of administration. Bacteriological relapses were seen after discontinuation of therapy in all treatment groups, but were not due to the development of resistant bacteria.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Child; Chloramphenicol; Cholera; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Paromomycin; Streptomycin; Tetracycline

Topics: Adolescent; Adult; Aged; Child; Cholera; Humans; India; Male; Middle Aged; Tetracycline; Vibrio

Topics: Anti-Bacterial Agents; Biofilms; Cholera; Humans; Image Processing, Computer-Assisted; Microscopy, Confocal; Tetracycline; Vibrio cholerae

Topics: Alleles; Anti-Bacterial Agents; Azithromycin; Cholera; Ciprofloxacin; Drug Resistance, Bacterial; Feces; Gene Transfer, Horizontal; Genotype; Haiti; Humans; India; Microbial Sensitivity Tests; Mutation; Phenotype; Polymerase Chain Reaction; Sequence Analysis, DNA; Tetracycline; Vibrio cholerae O1

The efficacy of commonly used antibiotics for treating severe cholera has been compromised over time because of the reduced antibiotic susceptibility. This study aimed to describe the rate of detection of

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Bangladesh; Child; Cholera; Ciprofloxacin; Drug Resistance, Bacterial; Erythromycin; Female; Furazolidone; Hospitals, Special; Humans; Male; Microbial Sensitivity Tests; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination; Vibrio cholerae O1

The antimicrobial susceptibility patterns and genetic characteristics of Vibrio cholerae O1, which is responsible for several cholera epidemics in Nigeria, are not reported in detail since 2007. In this study, we screened V. cholerae O1 El Tor biotype isolates from cholera cases and water samples from different states to investigate their phenotypic and genetic attributes with special reference to their clonality.. All the V. cholerae O1 biotype El Tor isolates isolated during 2007-2013 were susceptible to fluoroquinolones and tetracycline, the drugs currently used in the treatment of cholera cases in Nigeria. Emergence of CT genotype 7 (Haitian type of ctxB allele) was predominantly seen among Ogawa serotype and the CT genotype 1 (classical ctxB allele) was mostly found in Inaba serotype. Overall, V. cholerae O1 from clinical and water samples were found to be closely related as determined by the pulsed-field gel electrophoresis. V. cholerae isolates from Abia, Kano and Bauchi were found to be genetically distinct from the other states of Nigeria.. Fecal contamination of the water sources may be the possible source of the cholera infection. Combined prevalence of Haitian and classical ctxB alleles were detected in Ogawa and Inaba serotypes, respectively. This study further demonstrated that V. cholerae O1 with the ctxB has been emerged similar to the isolates reported in Haiti. Our findings suggest that the use of fluoroquinolones or tetracycline/doxycycline may help in the effective management of acute cholera in the affected Nigerian states. In addition, strengthening the existing surveillance in the hospitals of all the states and supply of clean drinking water may control cholera outbreaks in the future.

Topics: Alleles; Anti-Bacterial Agents; Cholera; Cholera Toxin; Cross-Sectional Studies; Electrophoresis, Gel, Pulsed-Field; Fluoroquinolones; Genotype; Humans; Microbial Sensitivity Tests; Nigeria; Polymerase Chain Reaction; Sequence Analysis, DNA; Serogroup; Tetracycline; Vibrio cholerae O1; Virulence

The epidemics of cholera were reported in the Kashipur, K.singhpur, B cuttack blocks of Rayagada district and Mohana block of Gajapati district of Odisha during 2010. The present study was carried out to isolate the bacterial pathogen, its drug sensitivity pattern and to describe the spread of the disease in those areas.. A total of 68 rectal swabs collected from patients with severe diarrhea, admitted to different health centers and diarrhea affected villages were bacteriologically analyzed. Similarly 22 water samples collected from different villages from nala, chua, etc were tested for the presence of V cholerae.. Out of 68 rectal swabs tested 35 (51.5%) were V cholerae O1 Ogawa and 14(20.6%) were E coli; which might be commensals. All water samples were negative for V cholerae. The V cholerae strains were sensitive to gentamicin, norfloxacin, ciprofloxacin, azithromycin and ofloxacin; but were resistant to ampicillin, tetracycline, nalidixic acid, furazolidone, streptomycin, erythromycin, co-trimoxazole, neomycin and chloramphenicol. All V cholerae strains were 100% resistant to tetracycline and they were El Tor variants harboring ctxB gene of classical strain.. The present study indicated the emergence and spread of tetracycline resistant V cholerae O1 El Tor variant in the tribal areas which needs close monitoring.

Topics: Anti-Bacterial Agents; Cholera; Epidemics; Humans; India; Tetracycline; Tetracycline Resistance; Vibrio cholerae O1

This study describes phenotypic, genotypic and antibiotic susceptibility patterns of the strains isolated from the 2012 Sierra Leone cholera outbreak. Rectal swabs were collected from patients and cultured for Vibrio cholerae O1.. The isolates were subjected to multiplex PCR, mismatch amplification mutation assay (MAMA) PCR, pulsed field gel electrophoresis (PFGE), and antibiotic sensitivity tests using disk diffusion and minimum inhibitory concentration (MIC) E-test following standard procedures.. Out of 17 rectal swabs tested, 15 yielded V. cholerae O1 biotype El Tor, serotype Ogawa. All the strains belonged to 'altered' variants as MAMA PCR result showed the presence of classical cholera toxin B. PFGE result revealed four pulse types. Using antibiotic disk diffusion, all the isolates were resistant to erythromycin, chloramphenicol, furazolidone, and trimethoprim/sulfamethoxazole (SXT) except SL1 which was sensitive to chloramphenicol and SXT. All the isolates were sensitive to nalidixic acid, tetracycline, doxycycline, azithromycin, and ciprofloxacin except SL2 which was resistant to nalidixic acid. However, variable sensitivity patterns were observed for kanamycin. The ranges of MIC were 0.125-0.50 mg/l, 0.003-0.023 mg/l and 0.38-0.75 mg/l for azithromycin, ciprofloxacin and tetracycline, respectively.. This study demonstrates that altered variants of V. cholerae O1 of four clonal types were responsible for the 2012 outbreak of cholera in Sierra Leone.

Topics: Anti-Bacterial Agents; Azithromycin; Bacterial Typing Techniques; Cholera; Ciprofloxacin; Disease Outbreaks; DNA, Bacterial; Dose-Response Relationship, Drug; Drug Resistance, Multiple, Bacterial; Electrophoresis, Gel, Pulsed-Field; Genotype; Humans; Microbial Sensitivity Tests; Sierra Leone; Tetracycline; Vibrio cholerae O1

Expression of a multidrug resistance transporter renders bacterial cells resistant to a variety of drugs. The major facilitator superfamily (MFS) comprises the largest group of bacterial multidrug transporters. There are over 20 MFS efflux pumps annotated on the genome of Vibrio cholerae, but little is known about their functions and regulation. In this study, five MFS efflux pumps were characterised, each of which is associated with a divergently transcribed putative LysR-type transcriptional regulator (MfsR). It was found that each of these MFS structural genes is regulated by the corresponding MfsR regulator. Deletion of these five mfs genes results in increased susceptibility to tetracycline and crude bile as well as a colonisation defect in an infant mouse colonisation model. Moreover, tetracycline and unknown intestinal signals could serve as co-inducers for the MfsR regulators. These data suggest that MFS efflux pumps are important both for antimicrobial resistance and V. cholerae pathogenesis.

Topics: Animals; Anti-Bacterial Agents; Bile Acids and Salts; Cholera; Disease Models, Animal; Drug Resistance, Multiple, Bacterial; Gene Deletion; Gene Expression Regulation, Bacterial; Membrane Transport Proteins; Mice; Tetracycline; Transcription Factors; Vibrio cholerae; Virulence

Topics: Anti-Bacterial Agents; Cholera; Disease Outbreaks; Humans; India; Microbial Sensitivity Tests; Tetracycline; Tetracycline Resistance; Vibrio cholerae O1

Vibrio cholerae O1 biotype El Tor (ET), causing the seventh cholera pandemic, was recently replaced in Bangladesh by an altered ET possessing ctxB of the Classical (CL) biotype, which caused the first six cholera pandemics. In the present study, V. cholerae O1 strains associated with endemic cholera in Dhaka between 2006 and 2011 were analysed for major phenotypic and genetic characteristics. Of 54 representative V. cholerae isolates tested, all were phenotypically ET and showed uniform resistance to trimethoprim/sulfamethoxazole (SXT) and furazolidone (FR). Resistance to tetracycline (TE) and erythromycin (E) showed temporal fluctuation, varying from year to year, while all isolates were susceptible to gentamicin (CN) and ciprofloxacin (CIP). Year-wise data revealed erythromycin resistance to be 33.3 % in 2006 and 11 % in 2011, while tetracycline resistance accounted for 33, 78, 0, 100 and 27 % in 2006, 2007, 2008, 2009 and 2010, respectively; interestingly, all isolates tested were sensitive to TE in 2011, as observed in 2008. All V. cholerae isolates tested possessed genetic elements such as SXT, ctxAB, tcpA(ET), rstR(ET) and rtxC; none had IntlI (Integron I). Double mismatch amplification mutation assay (DMAMA)-PCR followed by DNA sequencing and analysis of the ctxB gene revealed a point mutation at position 58 (C→A), which has resulted in an amino acid substitution from histidine (H) to asparagine (N) at position 20 (genotype 7) since 2008. Although the multi-resistant strains having tetracycline resistance showed minor genetic divergence, V. cholerae strains were clonal, as determined by a PFGE (NotI)-based dendrogram. This study shows 2008-2010 to be the time of transition from ctxB genotype 1 to genotype 7 in V. cholerae ET causing endemic cholera in Dhaka, Bangladesh.

Topics: Amino Acid Sequence; Anti-Bacterial Agents; Bacterial Typing Techniques; Bangladesh; Base Sequence; beta-Lactamases; Cholera; Ciprofloxacin; DNA, Bacterial; Drug Resistance, Multiple, Bacterial; Endemic Diseases; Erythromycin; Furazolidone; Genetic Variation; Gentamicins; Humans; Microbial Sensitivity Tests; Sequence Alignment; Sequence Analysis, DNA; Sulfamethoxazole; Tetracycline; Trimethoprim; Vibrio cholerae O1

Topics: Anti-Bacterial Agents; Cholera; Diarrhea; Feces; Humans; India; Microbial Sensitivity Tests; Population Surveillance; Prevalence; Risk Factors; Tetracycline; Tetracycline Resistance; Vibrio cholerae O1

Inducible character of resistance to tetracycline, chloramphenicol and ampicillin was investigated in 20 strains of Vibrio cholera non-O1/non-O139 serogroups isolated from inhabitants of Uzbekistan in 1990 (10 strains, ctx+) and in 2001 (5 strains, ctx-) and from inhabitants of Kalmykiya within 2003-2005 (5 strains, ctx-). Eight of the 20 isolates showed not only capacity for induction of the antibiotic resistance, but also its possible self transfer to Escherichia coli and reverse crosses in El Tor V. cholerae P-5879. It was shown that the effect of the antibacterial on the isolates phenotypic susceptibility could increase the resistance markers expression, when the genomes contained sites responsible for their expression, that required constant bacteriological control of the treatment efficacy and the use of the isolates antibioticograms for early replace of the inefficient drug by the efficient one. The prevalence of V. cholerae O1 and non-O1/non-O13 serogroups with multiple resistance to the antibacterial and the genetic potency for the antibiotic resistance development in the pathogen made difficult the choice of efficient drugs for prophylaxis and treatment of diseases caused by V. cholerae.

Topics: Ampicillin; Anti-Bacterial Agents; Chloramphenicol; Cholera; Drug Resistance, Multiple, Bacterial; Escherichia coli; Female; Humans; Male; Protein Synthesis Inhibitors; Russia; Tetracycline; Uzbekistan; Vibrio cholerae non-O1; Vibrio cholerae O139

Vibrio cholerae O1, Ogawa and Inaba serotypes, both cause severe cholera. We compared clinical and immunological features in patients in Bangladesh infected with these 2 serotypes. Blood was collected from hospitalized Ogawa (N=146) or Inaba (N=191) patients at the acute stage (day 2) and 5 and 19 days later. Ogawa patients were younger than Inaba, presented with shorter duration of diarrhoea, and had more frequent abdominal pain, vomiting and need for intravenous fluids (p<0.05). Inaba patients more frequently had dark-field positive stools (p<0.01). Inaba strains were more susceptible to tetracycline and erythromycin than Ogawa strains (p<0.001). Ogawa infection produced higher plasma vibriocidal as well as IgG responses to cholera toxin B subunit, toxin-coregulated pilus subunit and lipopolysaccharide (LPS); higher IgA responses to LPS in 'antibody in lymphocyte supernatant' (ALS) specimens were also seen. These results suggest that a cholera vaccine based on the Ogawa serotype needs to be further investigated.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Antibodies, Bacterial; Bangladesh; Child; Child, Preschool; Cholera; Cholera Toxin; Dehydration; Erythromycin; Feces; Female; Humans; Immunoglobulin G; Infant; Lipopolysaccharides; Male; Microbial Sensitivity Tests; Microbial Viability; Middle Aged; Serotyping; Tetracycline; Vibrio cholerae O1; Young Adult

Topics: Administration, Oral; Anti-Bacterial Agents; Caribbean Region; Cholera; Disease Outbreaks; Doxycycline; Drug Administration Schedule; Erythromycin; Fluid Therapy; Global Health; Haiti; Humans; Infusions, Intravenous; Latin America; Pandemics; Public Health; Rehydration Solutions; Sanitation; Tetracycline; Vibrio cholerae O1; Water Supply; World Health Organization

During 2003, Vibrio cholerae O1 Ogawa was the predominant serotype among diarrhoeal patients admitted to different hospitals in India. With the exception of 3 strains from Kolkata, none of 172 strains examined exhibited resistance to tetracycline, but 45.7 % showed reduced susceptibility to ciprofloxacin. Extensive molecular characterization using randomly amplified polymorphic DNA analysis, ribotyping and PFGE revealed that almost all the strains within a serogroup were clonally related. Along with the H pulsotype, a newly described L pulsotype of recently emerged O1 Inaba strains was detected among the O1 Ogawa strains from 2003. The striking similarity in their molecular properties and antibiograms indicated that at least certain clones of recently emerged Inaba strains from 2004 may have evolved from O1 Ogawa strains. This view was further supported by the detection of a nearly identical wbeT region among the O1 Ogawa and recently emerged Inaba strains, the latter differing only by a single point mutation. Since 2003, a hiatus in the isolation of serogroup O139 was observed and these strains share the same PFGE profiles as those isolated during 2000. Organization of tandemly arranged CTX(El), CTX(Cal) and truncated CTX(Cal) (devoid of ctxAB) prophages was unique among the majority of these O139 strains.

Topics: Anti-Bacterial Agents; Cholera; Ciprofloxacin; Cluster Analysis; DNA Fingerprinting; DNA, Bacterial; DNA, Viral; Drug Resistance, Bacterial; Electrophoresis, Gel, Pulsed-Field; Evolution, Molecular; Genotype; Humans; India; Molecular Epidemiology; Phenotype; Prophages; Random Amplified Polymorphic DNA Technique; Ribotyping; Tetracycline; Vibrio cholerae O1; Vibrio cholerae O139; Virulence Factors

Topics: Anti-Bacterial Agents; Bangladesh; Cholera; Colony Count, Microbial; Drug Resistance, Multiple, Bacterial; Humans; Microbial Sensitivity Tests; Tetracycline; Vibrio cholerae O1

All cases of cholera that have occurred at our center in north India have been due to Vibrio cholerae O1 serotype Ogawa, including the outbreaks in 2002 and 2004. Here we report the emergence of V. cholerae O1 biotype El Tor serotype Inaba for the first time in this region since July 2004. Fifteen Inaba isolates were obtained from 32 patients suffering from cholera-like illness. The patients lived in Chandigarh and the neighboring states of Punjab, Haryana, and Himachal Pradesh. All strains were resistant to nalidixic acid and trimethoprim, and showed moderate sensitivity to amoxycillin. All were sensitive to ciprofloxacin, tetracycline, cefotaxime, amikacin, and gentamicin. All strains were found to be toxigenic when tested with a commercial reverse passive latex agglutination kit. The last reported Inaba isolate dominance in India was observed in Calcutta in 1989. There is a need to closely watch the spread of serotype Inaba, as it may cause outbreaks in other parts of India; molecular studies are warranted to understand the widespread emergence of Inaba in north India.

Topics: Adolescent; Adult; Aged; Amikacin; Anti-Infective Agents; Cefotaxime; Child; Child, Preschool; Cholera; Ciprofloxacin; Disease Outbreaks; Drug Resistance, Bacterial; Female; Gentamicins; Humans; India; Male; Microbial Sensitivity Tests; Middle Aged; Nalidixic Acid; Tetracycline; Trimethoprim; Vibrio cholerae O1

Topics: Adult; Anti-Bacterial Agents; Bangladesh; Cholera; Drug Resistance; Female; Humans; In Vitro Techniques; Male; Tetracycline; Vibrio cholerae O1

Sensitivity testing on Vibrio cholerae isolates during an epidemic in 1998 in Kelantan identified strains resistant to tetracycline. This prompted a change in the usual management of cholera in Kelantan. The antibiotic of choice was changed from tetracycline to erythromycin.

Topics: Anti-Bacterial Agents; Cholera; Drug Resistance, Microbial; Erythromycin; Humans; Malaysia; Microbial Sensitivity Tests; Tetracycline; Vibrio cholerae

Ravages caused by cholera among children are well known. The disease invaded Madagascar in 1999 May. This retrospective study reported the first childhood cholera cases. The survey was carried out at the Befelatanana Hospital during the period of cholera outbreak from April 23th to July 31st. The purpose of the study was to specify clinical, epidemiological and bacteriological characteristics of the disease. 5 out of 178 suspected cholera cases were less than 15 years old. 2 young girls out these 5 children, inhabitants of Antananarivo-City were hospitalized for acute diarrhoea with serious dehydratation. Their disease was confirmed by bacteriology. Vibrio cholera O1 strain, serovar Ogawa was identified. Epidemiological investigation allowed to identify the contamination modal in the file no 1. The authors conclude that cholera is an important problem of public health in developing country like Madagascar. Disease control needs environmental sanitation and good individual hygiene practices.

Topics: Age Distribution; Anti-Bacterial Agents; Child; Cholera; Developing Countries; Disease Outbreaks; Female; Fluid Therapy; Hospitalization; Hospitals, General; Humans; Madagascar; Male; Population Surveillance; Public Health Practice; Retrospective Studies; Serotyping; Tetracycline; Vibrio cholerae O1

The authors describe the case of a fifty-nine-year-old white man, previously in good health, who initiated his present illness with acute episode of enterocolitis characterized by mild fever and, in the next eight hours, twenty-four episodes of watery diarrhea, nausea and vomiting, as well as generalized sweating and severe weakness secondary to hypovolemia and electrolyte disorder. These complications were corrected in seventy-two hours in the intensive care unit. Two days later, when the patient was stable hemodynamically, under cardiac monitoring and with normal laboratory studies including serum electrolytes, he developed electrocardiographic changes characterized by trifascicular block (prolonged P-R interval, complete right bundle branch block [CRBBB] and left posterior hemiblock [LPH]) with a cardiac rate of thirty beats per minute, for which a temporary pacemaker was inserted. Endomyocardial biopsy showed histopathologic signs of myocarditis and the immunologic study of the cardiac tissue revealed positive polymerize chain reaction (PCR+) with the presence of antitoxine choleric antibodies (AcTCA). After three weeks, the same conduction disturbances remained, for which a permanent pacemaker was inserted. On top of intravenous fluid replacement and electrolyte supplements, the patient was managed with tetracycline 2 g a day for one week and sulfamethoxazole-trimethoprim 800/160 mg a day for two weeks. The purpose of this study is to present a rare and very well-documented myocarditis by cholera in a patient with enteric disease, in whom several cardiac complications occurred.

Topics: Anti-Bacterial Agents; Antibodies, Bacterial; Bradycardia; Bundle-Branch Block; Cholera; Diarrhea; Electrocardiography; Enterocolitis; Humans; Male; Middle Aged; Myocarditis; Nausea; Pacemaker, Artificial; Polymerase Chain Reaction; Sweating; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination; Vibrio cholerae; Vomiting

Topics: Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents, Urinary; Cholera; Drug Resistance, Microbial; Ecuador; Erythromycin; Humans; Nitrofurans; Nitrofurantoin; Penicillins; Polymyxin B; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination; Vibrio cholerae

In July, 1994, in one of the worst cholera outbreaks in recent times, an estimated 12,000 Rwandan refugees died in Goma in eastern Zaire. The Vibrio cholerae strains were resistant to tetracycline and doxycycline, the commonly used drugs for cholera treatment. Despite the efforts of international organisations, which provided medical relief by establishing treatment centres in Goma, mortality from the disease was much higher than expected. In the area of Muganga camp, which had the largest concentration of refugees and where most of the medical aid organisations were active, the highest reported case-fatality ratio for a single day was 48%. The slow rate of rehydration, inadequate use of oral rehydration therapy, use of inappropriate intravenous fluids, and inadequate experience of health workers in management of severe cholera are thought to be some of the factors associated with the failure to prevent so many deaths during the epidemic. In one of the temporary treatment centres with the worst case-fatality record, our team showed that improvement of these factors could increase the odds of survival of cholera patients even in a disaster setting.

Topics: Ambulatory Care Facilities; Cholera; Clinical Competence; Democratic Republic of the Congo; Disasters; Doxycycline; Drug Resistance, Microbial; Fluid Therapy; Health Personnel; Humans; International Agencies; Refugees; Relief Work; Rwanda; Tetracycline; Vibrio cholerae

Vibrio cholerae O139 Bengal has recently emerged as a cause of epidemic cholera in Asia. To evaluate clinical and immunologic responses to infection, V. cholerae O139 Bengal AI1837 was administered to healthy adult North American volunteers. Two of 4 persons ingesting 10(4) cfu became ill (incubation period, 48 h; mean diarrheal stool, 1873 g), as did 7 of 9 persons receiving 10(6) cfu (incubation period, 28 h; mean diarrheal stool, 4548 g). Ill volunteers did not demonstrate a vibriocidal antibody response to the challenge strain or other V. cholerae. Three months later, volunteers were rechallenged with the homologous O139 Bengal strain. Only 1 of 6 persons who had been ill on initial challenge had diarrhea, compared with 11 of 13 controls (P = .01; protective efficacy = 80%). V. cholerae O139 Bengal can cause severe diarrhea typical of cholera, with clinical characteristics and a dose-response similar to those seen with V. cholerae O1 El Tor. A moderately high level of protection against subsequent disease is provided by initial clinical infection.

Topics: Adult; Antibodies, Bacterial; Cholera; Diarrhea; Feces; Humans; Immunity, Active; Tetracycline; Vibrio cholerae

Topics: Cholera; Denmark; Female; Fluid Therapy; Humans; Middle Aged; Tetracycline; Vibrio cholerae; Vietnam

Within 24 hours of returning from a five-week holiday in Pakistan a 15-year-old girl developed vomiting and massive diarrhoea leading to severe dehydration with hypovolaemic shock. The diastolic blood pressure was no longer measurable and prerenal renal failure occurred with a serum creatinine of 4.4 mg/dl and metabolic acidosis (pH 7.21, base excess-16.9 mmol). Initially treatment consisted of rehydration (day 1: 9280 ml, day 2: 4850 ml). The patient's condition rapidly improved and she had voluminous stools. A concurrent urinary infection due to Klebsiella pneumoniae was first treated with cotrimoxazole. As a new strain of Vibrio cholerae, serogroup O 139, was isolated from stool, treatment was changed to tetracycline (50 mg/kg daily). Regaining a good general state she was transferred to an isolation ward on the 6th hospital day. The isolated cholera organism belongs to a nonagglutinating serogroup which is indistinguishable clinically and epidemiologically from the classical Vibrio strains which cause cholera. Since the end of 1992 this new serogroup has been causing an explosive spread of cholera in Bangladesh and India.

Topics: Adolescent; Agglutination Tests; Cholera; Dehydration; Feces; Female; Fluid Therapy; Germany; Humans; Klebsiella Infections; Klebsiella pneumoniae; Pakistan; Serotyping; Shock; Tetracycline; Travel; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections; Vibrio cholerae

Although the existence of chronic carriers of Vibrio cholerae has been posited, the information in this regard is limited and contradictory. In order to determine the usefulness of the encapsulated string test (enterotest) for detecting V. cholerae in duodenal secretions of biliary origin (biliduodenal secretions), 59 patients (30 males and 29 females) over the age of 15 with clinically and bacteriologically diagnosed cholera were evaluated. All the patients, who were treated at the María Auxiliadora Departmental Hospital in Lima, Peru, were put on the same rehydration regimen and were given 2 g of tetracycline daily for 3 days. Between 24 h and 7 days after completion of the antibiotic treatment the first control tests were performed: culture of biliduodenal secretions obtained using enterotest and culture of feces obtained by rectal swab. No patient had diarrhea at the time of the first test. The biliduodenal secretion cultures revealed the presence of V. cholerae in five patients (8.5%) (four females and one male), while the fecal culture yielded negative results in all cases. One week later the control test was repeated on four of the five patients. All the biliduodenal secretion cultures were negative and only one fecal culture was positive at this stage. The patient in question was subjected to the same control tests one week later and both were negative. It is concluded that enterotest can be a simple, well-tolerated, low-cost method for detecting V. cholerae carriers.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bacteriological Techniques; Carrier State; Cholera; Convalescence; Feces; Female; Gastrointestinal Contents; Humans; Male; Middle Aged; Tetracycline; Vibrio cholerae

Since 1961 cholera has spread in many countries reaching a pandemic form. Since 1991 Mexico has been involved in this pandemia. Near 20% of all cases of cholera in our country happen in fertile women, so the possibility of the association between cholera and pregnancy is high. We present the case of a pregnant woman, who during her third trimester presented a episode of cholera, developing premature labor. Furthermore is revised the medical literature about the general principles of the management of cholera, and the association between pregnancy and the intestinal infection.

Topics: Adult; Cholera; Female; Humans; Infant, Newborn; Mexico; Obstetric Labor, Premature; Parity; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, Third; Tetracycline

This study showed that the strains of Vibrio cholerae El Tor, Ogawa serotype, isolated during the last cholera outbreak in Benin (1991) are widely sensitive to tetracyclin (84%), sulfamid (96%), ampicillin (98%).

Topics: Ampicillin; Benin; Cholera; Humans; Microbial Sensitivity Tests; Serotyping; Sulfanilamides; Tetracycline; Vibrio cholerae

The efficacy of ciprofloxacin, norfloxacin and tetracycline in prevention of colonisation of V. cholerae O1 in the rabbit intestine were tested. V. cholerae O1 highly colonised the gut of rabbits which did not receive any antibiotic. All antibiotics tested inhibited the colonisation of V. cholerae O1 within the rabbit intestine. Moreover, ciprofloxacin and norfloxacin were found to be as effective as tetracycline suggesting that these drugs should be subjected to clinical trials for the treatment of cholera in comparison with tetracycline.

Topics: Animals; Anti-Bacterial Agents; Cholera; Ciprofloxacin; Disease Models, Animal; Evaluation Studies as Topic; Intestines; Microbial Sensitivity Tests; Norfloxacin; Rabbits; Tetracycline; Vibrio cholerae

Among 87 strains of Vibrio choleare (78 Ogawa serotype and 9 Inaba serotype strains) isolated in Angola in 1987-1990, 86% exhibited multiple resistance to antimicrobials. Eighty-four to 86% of strains were resistant to ampicillin with beta-lactamase production (MIC greater than or equal to 512 mg/l), streptomycin (MIC greater than or equal to 64 mg/l), spectinomycin (MIC greater than or equal to 1,024 mg/l), and trimethoprime-sulfisoxazole (MIC greater than 1,024 mg/l). Seventy-four per cent of strains were resistant to kanamycin (MIC = 512 mg/l), 26% to chloramphenicol (MIC = 32 mg/l), 10% to tetracycline (MIC = 16 mg/l), and 10% to gentamycin (MIC greater than or equal to 32 mg/l). Transfer to E. coli K12 was associated with a substantial increase in expression of resistance to tetracycline and chloramphenicol (CAT type I), with MICs in the 128-512 mg/l range. Transfer rates to E. coli K12 of plasmids for the various resistance phenotypes were 10(-6)/10(-8). The size of the isolated plasmids was 100 Md in diameter and belonged to the incompatibility group inc 6-C.

Topics: Angola; Anti-Bacterial Agents; Chloramphenicol; Chloramphenicol Resistance; Cholera; DNA, Bacterial; Drug Resistance, Microbial; Escherichia coli; Humans; In Vitro Techniques; Plasmids; Sulfanilamides; Tetracycline; Tetracycline Resistance; Transfection; Vibrio cholerae

The ability of tetracycline and clioquinol to prevent intestinal colonization of Vibrio cholerae and Escherichia coli was tested in a rabbit model. In the model 10(10) bacteria are given via oro-gastric tube following intravenous cimetidine and oral sodium bicarbonate and prior to intraperitoneal tincture of opium. Eighteen hours after challenge the rabbits are sacrificed, and the numbers of the challenge strain remaining in the jejunum and ileum are determined. Tetracycline interrupted the intestinal colonization of V. cholerae and E. coli. Clioquinol however, had minimal effect on the colonization process. Our studies demonstrate the efficacy of prophylactic tetracycline but do not support the use of clioquinol to prevent intestinal infection due to these organisms. This rabbit model may also be useful to study the efficacy of other antibiotics against these bacterial infections.

Topics: Animals; Cholera; Clioquinol; Escherichia coli; Escherichia coli Infections; Female; Hydroxyquinolines; Male; Microbial Sensitivity Tests; Rabbits; Tetracycline; Vibrio cholerae

During an epidemic of cholera, vaccination has limited applicability in controlling its spread. It has been seen that one out of every five to 10 V. cholerae-infected people develops diarrhoea severe enough to require hospital treatment. Most health authorities are concerned with this severely ill group in whom the majority of deaths occur. During the cholera epidemic of 1975 in Dacca two doses of tetracycline were administered to all family contacts of index cases. The control group of cholera cases did not receive the drug. The families were re-visited after 10-12 days and history of any diarrhoea and hospitalization was obtained. It was found that the subsequent diarrhoea or cholera cases occurring among the cholera contacts within 10-12 days were not different between the treated (13.5%) and the untreated (14.4%) groups. The occurrence of severe cases requiring hospitalization was, however, significantly reduced in the treated group (8.0% to 4.5%). In view of the emergence of V. cholera strains resistant to tetracycline, antibiotic sensitivity testing of epidemic strains would be needed before use of tetracycline for protecting cholera contacts as an immediate control measure.

Topics: Adolescent; Adult; Bangladesh; Child; Child, Preschool; Cholera; Diarrhea; Disease Outbreaks; Female; Humans; Infant; Male; Tetracycline

Five hundred sixty-one persons were treated in a comprehensive cholera unit during the 1979-1980 cholera outbreak at Ile-Ife. Sixty-one pregnant cholera patients were identified and followed up. Compared to the general female population, all female cholera patients in the 15-29 year age group show significantly more resistance to the disease than those aged 30 years and above. The pregnant cases, as well as all reproductive-years age groups, showed significantly less mortality than both the non-pregnant patients and those at both extremes of age. Our findings show that pregnancy does not render the woman more susceptible and may, in fact, render her less susceptible after the first trimester, when prognosis brightens for both the mother and the fetus.

Topics: Adult; Age Factors; Aged; Cholera; Disease Outbreaks; Female; Humans; Male; Middle Aged; Occupations; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, First; Prognosis; Seasons; Tetracycline

Topics: Carrier State; Cholera; Disease Outbreaks; Feces; Humans; Malawi; Tetracycline; Vibrio cholerae

110 El Tor Vibrio cholerae isolates from 102 patients with cholera between November, 1977, and March, 1978, during the early stages of the fourth epidemic of cholera in Tanzania had minimum inhibitory concentrations to tetracycline, chloramphenicol, nitrofurantoin, neomycin, ampicillin, and sulphadimidine determined. All isolates during the first month after the disease was recognised were fully sensitive to tetracycline, but 76% of isolates were resistant to the drug after five months of extensive use of tetracycline therapeutically and prophylactically in the country. Resistance to the five other antibacterial agents developed more slowly. Isolates from patients who failed to clear the organism from their stools or who had cholera soon after tetracycline prophylaxis had increased minimum inhibitory concentrations of the drug. Resistance did not develop in vivo. Although resistance to tetracycline readily developed following extensive use of the drug, such a resistance was not the only reason for failure of tetracycline treatment and prophylaxis. Mass chemoprophylaxis in the control of cholera should be discouraged unless evidence to the contrary becomes available.

Topics: Ampicillin; Chloramphenicol; Cholera; Disease Outbreaks; Feces; Humans; Neomycin; Nitrofurantoin; Penicillin Resistance; Sulfamethazine; Tanzania; Tetracycline; Time Factors; Vibrio cholerae

Topics: Animals; Anti-Bacterial Agents; Asia, Eastern; Bacteria; Cholera; Diarrhea; Doxycycline; Drug Resistance, Microbial; Gonorrhea; Humans; Infection Control; Male; Minocycline; Mucous Membrane; R Factors; Tetracycline; United States

Topics: Cholera; Dysentery, Bacillary; Humans; Male; Middle Aged; Tetracycline

An epidemic of cholera due to Vibrio cholerae biotype El Tor occurred in 1977 on Tarawa in the Gilbert Islands. No cholera epidemic had occurred there previously and special problems were encountered in both the diagnosis and clinical management. The clinical features of the 585 hospital admissions on Tarawa during the first 64 days of the epidemic were recorded. Eight hospital deaths occurred in this period. A marked increase in cholera among malnourished Gilbertese children was noted. Simplified regimes for management were devised for the circumstances including schemes for oral and intravenous rehydration. Coconut water was used extensively in oral rehydration. Paramedical personnel were used effectively during the epidemic. Prophylactic tetracycline was used in household contacts of patients and was effective in reducing subsequent illness.

Topics: Cholera; Dehydration; Disease Outbreaks; Feces; Humans; Micronesia; Nutrition Disorders; Tetracycline; Vibrio cholerae

Topics: Carrier State; Cholera; Drug Combinations; Humans; Sulfamethoxazole; Tetracycline; Trimethoprim

The efficacy of trimethoprim-sulphamethoxazole (TMP-SMX) has been compared with that of tetracycline and chloramphenicol in 175 bacteriologically confirmed cases of cholera admitted to the Infectious Diseases Hospital Delhi. Vibrio cholerae, biotype El Tor, serotype ogawa, were isolated from all the patients. TMP-SMX showed greater in vitro inhibition and earlier eradication from the intestinal tract and is recommended as a suitable vibriocidal agent against cholera.

Topics: Chloramphenicol; Cholera; Drug Combinations; Humans; India; Sulfamethoxazole; Tetracycline; Trimethoprim; Vibrio cholerae

67 of the bacteriologically proved adult acute cholera patients have been examined in order to evaluate the efficacy of TM-SMX in comparison with tetracycline and chloramphenicol in the eradication of Vibrio cholerae from stools. Our results demonstrated that all three drugs sterilized the stools of all patients within 3 days with the exception of one case of TM-SMX's group, which had negative culture stools after 4 days. On the basis of our experience it can be emphasized that TM-SMX can support chloramphenicol and tetracycline in the antibacterial treatment of cholera with the advantage that the drug is efficacious with daily administrations.

Topics: Adult; Chloramphenicol; Cholera; Drug Combinations; Drug Evaluation; Feces; Humans; Sulfamethoxazole; Tetracycline; Trimethoprim; Vibrio cholerae

Higher stability of resistance to tetracycline in the polyresistant strain of V. eltor under conditions of macroorganism as compared to nutrient media was found experimentally. To increase isolation of the resistant forms of the cholera vibrio it was recommended to use agar with tetracycline or other antibiotics depending on the particular case in addition to the routine media.

Topics: Animals; Anti-Bacterial Agents; Chloramphenicol; Cholera; Crosses, Genetic; Culture Media; Drug Resistance, Microbial; Escherichia coli; Extrachromosomal Inheritance; Microbial Sensitivity Tests; R Factors; Rabbits; Streptomycin; Tetracycline; Vibrio cholerae

A case of cholera admitted to the Pahlavi University Medical Centre is presented and the aetiology, pathophysiology, complications and treatment of the disease are reviewed and discussed.

Topics: Bangladesh; Cholera; Female; Humans; Middle Aged; Parenteral Nutrition; Tetracycline; Water-Electrolyte Balance

Cholera varies greatly in clinical severity; the mortality of untreated severe cholera may be as high as 60% The main clinical feature is dehydration; fluid lost in the stools may amount to 60/. Rehydration is the cornerstone of treatment. The amount of fluid required is approximately 10% of body weight in severe dehydration and 5 to 8% in moderate dehydration. Fluid therapy, which must be individualized, may be successful on its own, but chemo-therapy shortens the duration of illness. Tetracycline (in adults, 40 mg/kg for 2 days; in children, 50 mg/kg for 2 days) reduces the fluid loss and eliminates the causative organisms. Vaccination is of limited value.

Topics: Adult; Bicarbonates; Child; Chloramphenicol; Cholera; Dehydration; Female; Furazolidone; Humans; Lactates; Pregnancy; Tetracycline; Vibrio cholerae

Topics: Adult; Aged; Cholera; Female; Humans; Male; Middle Aged; Sulfadoxine; Sulfanilamides; Tetracycline

Sulfadoxine, a long-acting sulfonamide, and tetracycline were compared as regards their effectiveness in reducing transmission of cholera infection among the contacts of cholera patients in Calcutta. A total of 109 healthy family contacts of confirmed hospitalized cholera patients were treated with a single oral dose of sulfadoxine graded according to age. Another similar group of 101 contacts received 6 divided doses of oral tetracycline over a period of 3 days. All these contacts were bacteriologically examined for 15 days. Results showed that tetracycline was effective in significantly reducing the load of cholera infection from the 2nd to 6th day, while sulfadoxine was effective from the 3rd to the 6th day. The advantages and disadvantages of the two drugs as chemoprophylactic agents in cholera are discussed.

Topics: Administration, Oral; Cholera; Drug Evaluation; Humans; India; Sulfadoxine; Sulfanilamides; Tetracycline

The feces of five patients admitted to a hospital during an outbreak of cholera in Melbourne, Australia, in November 1972, were examined for the presence of tetracycline-resistant coliforms and tetracycline-resistant strains of Vibrio cholerae. Despite the abundance of tetracycline-resistant coliforms able to transfer this resistance to other strains of Escherichia coli, no tetracycline-resistant strains of V. cholerae were detected. In vitro transfer experiments using the V. cholerae strain responsible for the outbreak as recipient revealed that it was a particularly poor host for most R plasmids.

Topics: Cholera; Conjugation, Genetic; Drug Resistance, Microbial; Escherichia coli; Extrachromosomal Inheritance; Feces; Gene Frequency; Humans; Microbial Sensitivity Tests; Plasmids; R Factors; Tetracycline; Vibrio cholerae

Topics: Cholera; Costs and Cost Analysis; Disease Outbreaks; Humans; Sulfonamides; Tetracycline; Vibrio cholerae; Water-Electrolyte Balance; Zimbabwe

Topics: Adolescent; Adult; Cholera; Diphenoxylate; Drug Therapy, Combination; Humans; Isonipecotic Acids; Male; Middle Aged; Tetracycline

Topics: Bangladesh; Cholera; Costs and Cost Analysis; Disease Outbreaks; Economics, Medical; Humans; Tetracycline

Topics: Chloramphenicol; Cholera; Cholera Vaccines; Humans; Immunity, Active; Sulfonamides; Tetracycline

Topics: Adult; Cholera; Humans; Male; Minocycline; Tetracycline

Topics: Ampicillin; Anti-Bacterial Agents; Chloramphenicol; Cholera; Humans; Penicillin G; Penicillin Resistance; Streptomycin; Tetracycline; Vibrio cholerae

Topics: Animals; Antitoxins; Bacteriological Techniques; Blood Proteins; Cholera; Cross Reactions; Diarrhea; Dogs; Enterotoxins; Escherichia coli; Humans; Intestinal Secretions; Jejunum; Neutralization Tests; Rabbits; Sodium; Temperature; Tetracycline; Time Factors; Vibrio cholerae

Topics: Cholera; Cholera Vaccines; Disease Outbreaks; Humans; International Cooperation; Tetracycline; Travel; Vaccination

Topics: Carrier State; Cholera; Disease Outbreaks; England; Feces; Food Contamination; History, 19th Century; History, 20th Century; Humans; Sanitation; Seasons; Tetracycline; Vibrio; Water Microbiology; Water Supply

Topics: Chloramphenicol; Cholera; Drug Evaluation; Humans; Quarantine; Tetracycline

Topics: Cholera; Cholera Vaccines; Communicable Disease Control; Disease Outbreaks; Foodborne Diseases; Humans; Intestines; Italy; Population Surveillance; Tetracycline

Topics: Botulism; Chloramphenicol; Cholera; Clostridium perfringens; Codeine; Diarrhea; Dysentery, Amebic; Dysentery, Bacillary; Escherichia coli Infections; Food; Foodborne Diseases; Humans; Opium; Oxytetracycline; Salmonella Infections; Staphylococcus; Stress, Physiological; Tetracycline; Travel; Virus Diseases

Topics: Blood Transfusion; Child; Child, Preschool; Cholera; Escherichia coli; Feces; Female; Gastroenteritis; Humans; Indonesia; Infant; Infant, Newborn; Male; Salmonella; Shigella dysenteriae; Tetracycline; Vibrio; Water-Electrolyte Balance

Topics: Acidosis; Administration, Oral; Adolescent; Adult; Aged; Bangladesh; Bicarbonates; Child; Child, Preschool; Cholera; Dehydration; Diarrhea; Female; Glucose; Humans; Infant; Injections, Intravenous; Male; Middle Aged; Refugees; Sodium Chloride; Solutions; Tetracycline; Vomiting; Water-Electrolyte Balance

Topics: Adult; Bangladesh; Child; Cholera; Drug Combinations; Drug Resistance, Microbial; Female; Humans; Infusions, Parenteral; Male; Microbial Sensitivity Tests; Sulfamethoxazole; Tetracycline; Trimethoprim; Vibrio cholerae

Topics: Adolescent; Adult; Aged; Carrier State; Cholera; Female; Humans; Male; Middle Aged; Tetracycline; Time Factors

Topics: Adolescent; Adult; Aged; Carrier State; Cholera; Female; Gastric Mucosa; Humans; Intestinal Mucosa; Male; Middle Aged; Tetracycline; Vibrio cholerae

Topics: Adult; Aerospace Medicine; Air Movements; Animals; Child; Chloramphenicol; Cholera; Cholera Vaccines; Diarrhea; Disease Vectors; Humans; Italy; Neomycin; Seasons; Sulfaguanidine; Tetracycline; Vibrio cholerae

Intestinal antibody (coproantibody) significantly reduced the adsorption of heat-killed Vibrio cholerae to the mucosa of in vivo isolated ileal loops of adult rabbits. This suggests a direct effect of coproantibody on adsorption, which appears to function in addition to the antibacterial mechanism described earlier. When antivibrio serum was administered passively into intestinal loops, it showed a predilection for the intestinal mucosa. In vivo adsorption of vibrios appeared to parallel their viability, i.e., vibrios killed by heat or in the presence of neomycin adsorbed significantly less than live vibrios. In contrast, in vivo adsorption was only slightly affected in the presence of bacteriostatic concentrations of tetracycline. Adsorption of Salmonella senftenberg and V. cholerae to slices of rabbit ileum in Krebs-Ringer solution appeared to involve different mechanisms, in that the former was strongly removed from the intestinal tissues by sodium lauryl sulfate, whereas vibrios were not affected by this agent. Triton X-100 increased the adsorption of vibrios, whereas rabbit bile and changes in pH had no effect.

Topics: Adsorption; Animals; Antibodies, Bacterial; Antigens, Bacterial; Cholera; Feces; Ileum; Immune Sera; Immunoglobulin A; In Vitro Techniques; Intestinal Mucosa; Neomycin; Rabbits; Salmonella; Surface-Active Agents; Tetracycline; Vibrio

Topics: Bicarbonates; Child; Chloramphenicol; Cholera; Glucose; Humans; Hypotonic Solutions; Infusions, Parenteral; Meningitis; Potassium; Sodium; Tetracycline; Water-Electrolyte Balance

Topics: Administration, Oral; Age Factors; Bicarbonates; Child; Child, Preschool; Chlorides; Cholera; Cholera Vaccines; Dehydration; Feces; Furazolidone; Humans; Infant; Infusions, Parenteral; Injections, Intravenous; Intestine, Small; Potassium; Sodium; Tetracycline; Water-Electrolyte Balance

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Cholera; Female; Humans; Infant; Infusions, Parenteral; Leukocyte Count; Male; Medical Staff, Hospital; Middle Aged; Nigeria; Potassium; Pregnancy; Pregnancy Complications, Infectious; Seasons; Specific Gravity; Tetracycline; Urea

Topics: Cholera; Humans; Sulfonamides; Tetracycline; Vaccination

Topics: Carbon Isotopes; Cholera; Feces; Humans; Intestinal Absorption; Intestine, Small; Mannitol; Tetracycline; Tritium

Topics: Adolescent; Adult; Age Factors; Aged; Child; Child, Preschool; Cholera; Disease Outbreaks; Ethnicity; Feces; Female; Humans; Infant; Israel; Male; Middle Aged; Prognosis; Social Conditions; Socioeconomic Factors; Tetracycline; Vibrio; Water Supply

Topics: Africa, Northern; Africa, Western; Asia, Southeastern; Body Fluids; Cholera; Cholera Vaccines; Humans; Tetracycline; Travel; Turkey; Water-Electrolyte Balance

Topics: Acute Kidney Injury; Cholecystitis; Cholera; Dehydration; Diarrhea; Gangrene; Humans; Hyperaldosteronism; Hypokalemia; Parotitis; Respiratory Tract Diseases; Shock; Tetany; Tetracycline; Vibrio cholerae; Water-Electrolyte Balance

Topics: Bicarbonates; Cholera; Diarrhea; Feces; Gastric Acidity Determination; Humans; Infusions, Parenteral; Male; Tetracycline; Vibrio; Water Microbiology

Topics: Adult; Cholecystokinin; Cholera; Escherichia coli; Feces; Humans; Ileum; Intestine, Small; Intubation, Gastrointestinal; Jejunum; Male; Saliva; Stomach; Tetracycline; Vibrio

Topics: Adolescent; Adult; Age Factors; Aged; Agglutination Tests; Antibodies; Bacteriological Techniques; Carrier State; Chloramphenicol; Cholera; Convalescence; Furazolidone; Humans; India; Magnesium Sulfate; Male; Middle Aged; Sulfaguanidine; Tetracycline; Time Factors

Each member of a group of 8 patients with acute cholera was treated with a mixture of four cholera bacteriophage preparations containing over 2 x 10(12) phage particles/ml. These massive doses were intended to kill immediately all vibrios in the intestine by "lysis from without". The numbers of Vibrio cholerae were drastically reduced rapidly. In 4 patients, V. cholerae was completely eliminated from the stools early in the treatment; the total stool volume and after-treatment of diarrhoea were reduced in comparison with a control group but were higher than in a group of patients treated with tetracycline. In the other 4 patients treated with phage, vibrios disappeard more slowly from the stools and there was no apparent clinical effect of the phage. In all the patients treated with phage, the duration of diarrhoea was longer than in patients in a control group who excreted vibrios for a similar length of time although the stool output was similar. This was interpreted as being due to the persistence of vibrios in foci of infection in the upper intestine.It is concluded that treatment of cholera with massive doses of bacteriophage is not as effective as treatment with tetracycline. However, phage can selectively eliminate the majority of vibrios without affecting the other intestinal flora and without any apparent toxic effect on the patient. Phage might therefore be useful as a research tool.

Topics: Acute Disease; Animals; Bacteriophages; Cholera; Diarrhea; Feces; Haplorhini; Humans; Rabbits; Tetracycline; Time Factors; Vibrio

Among 1109 patients with bacteriologically confirmed El Tor cholera admitted to the San Lazaro Hospital, Manila, in 1969, 11 patients continued to excrete vibrios of the same biotype and serotype in stools for more than 1 week in spite of antibiotic treatment.The strains isolated from these patients all belonged to the Ogawa serotype and were all highly resistant to streptomycin and chloramphenicol, and a few of them were resistant also to tetracycline. Other streptomycin-resistant strains of El Tor vibrio were detected, 5 in the Greater Manila area and 1 in Bacolod.The antibiotic-resistant strains showed a high sensitivity to 3 kinds of antimicrobial chemicals, particularly dihydroxymethyl furalazine.Furalazine was given to 33 adults and 15 children with bacteriologically confirmed cholera, and its effect in reducing the duration of diarrhoea and excretion of vibrios was investigated in comparison with the same number of cases treated with chloramphenicol. Furalazine was more effective in reducing the duration of positive stool culture than chloramphenicol, and the two antimicrobial agents were equally effective in decreasing intravenous fluid requirements.Since furalazine was satisfactory in reducing the duration of diarrhoea and excretion of vibrios in stools, and since no resistant strains were found, the drug could be recommended as an alternative to chloramphenicol and tetracycline in the treatment of cholera.

Topics: Adolescent; Adult; Child; Child, Preschool; Chloramphenicol; Cholera; Diarrhea; Drug Resistance, Microbial; Feces; Female; Humans; Male; Microbial Sensitivity Tests; Nitrofurans; Philippines; Tetracycline; Triazines; Vibrio

Tetracycline continues to be an effective antimicrobial agent in the clinical control of cholera but because of its high cost, relatively short shelf-life and recent reports of increased resistance of vibrios to tetracycline in vitro, alternative antimicrobial agents have been tested. Furazolidone, effective against cholera caused by the El Tor biotype in adults, was found to be as effective as tetracycline in reducing the volume and duration of diarrhoea in children with classical cholera and, given over a period of 7 days, only slightly less effective in reducing duration of vibrio excretion.Therapy with an antimicrobial agent over a period of 7 days was associated with a significantly smaller rise in vibriocidal antibody titre (of no clinical significance) in the youngest age-group studied; this was probably due to a diminished antigenic stimulus from the primary infection. Undernourished children showed a poorer response to anti-microbial therapy.The study indicated that furazolidone is a reasonable alternative to tetracycline in the treatment of cholera.

Topics: Antibody Formation; Body Weight; Child; Child, Preschool; Cholera; Diarrhea; Feces; Female; Furazolidone; Humans; Male; Tetracycline; Time Factors; Vibrio

Topics: Adolescent; Adult; Aged; Animals; Antibody Formation; Antitoxins; Cholera; Diarrhea; Disease Reservoirs; Humans; Male; Middle Aged; Rabbits; Tetracycline; Time Factors; Vibrio

Topics: Animals; Cholera; Cholera Vaccines; Diagnosis, Differential; Humans; Immunotherapy; Mice; Rabbits; Tetracycline

Topics: Adult; Bacteriophages; Child; Cholera; Female; Humans; Isotonic Solutions; Tetracycline; Vibrio

Topics: Anti-Bacterial Agents; Cholera; Humans; Tetracycline

Topics: Adult; Child; Cholera; Female; Humans; Male; Middle Aged; Tetracycline

Topics: Aminosalicylic Acids; Ampicillin; Anti-Bacterial Agents; Cephaloridine; Chloramphenicol; Chlortetracycline; Cholera; Dihydrostreptomycin Sulfate; Erythromycin; Erythromycin Ethylsuccinate; Kanamycin; Liver Extracts; Neomycin; Oleandomycin; Oxacillin; Oxytetracycline; Penicillin Resistance; Penicillins; Polymyxins; Protamines; Streptomycin; Tetracycline; Vibrio; Water Microbiology

Topics: Adult; Carrier State; Cholera; Furazolidone; Humans; Male; Tetracycline; Vibrio

Topics: Anti-Bacterial Agents; Chloramphenicol; Chlortetracycline; Cholera; Drug Resistance, Microbial; Kanamycin; Methods; Neomycin; Oxytetracycline; Penicillin Resistance; Streptomycin; Tetracycline; Vibrio

Topics: Anti-Bacterial Agents; Chloramphenicol; Cholera; Humans; Streptomycin; Tetracycline; Water-Electrolyte Balance

Topics: Adolescent; Carrier State; Cholera; Feces; Humans; Tetracycline; Vibrio

Topics: Biopsy; Cholera; Diarrhea; Dysentery, Amebic; Humans; Intestine, Small; Jejunum; Malabsorption Syndromes; Tetracycline; Typhoid Fever

In a controlled trial of the effects of oral antibiotics in treating cholera in children in Dacca, East Pakistan, tetracycline was the most effective of 4 antibiotics tested in reducing stool volume, intravenous fluid requirement, and the duration of diarrhoea and positive stool culture. Increasing the duration of tetracycline therapy from 2 to 4 days, or increasing the total dose administered, resulted in shorter duration of positive culture, but did not affect stool volume or duration of diarrhoea. Only 1% of the children receiving tetracycline had diarrhoea for more than 4 days. Tetracycline was significantly more effective than intravenous fluid therapy alone, regardless of severity of disease.Chloramphenicol, while also effective, was inferior to tetracycline. Streptomycin and paromomycin exerted little or no effect on the course of illness or duration of positive culture. Therapeutic failures with these drugs were not due to the development of bacterial resistance.From these findings, tetracycline appears to be the drug of choice against Vibrio cholerae infection in children. Oral therapy for 48 hours is effective clinically, but is associated with 20% bacteriological relapses when the drug is discontinued; it is not known whether extending the therapy for a week or more would eliminate such relapses.

Topics: Anti-Bacterial Agents; Child; Child, Preschool; Chloramphenicol; Cholera; Humans; Infant; Infusions, Parenteral; Pakistan; Paromomycin; Streptomycin; Tetracycline

Topics: Chloramphenicol; Cholera; Humans; Tetracycline

Topics: Adolescent; Adult; Aged; Cholera; Feces; Female; Humans; Male; Middle Aged; Tetracycline

Topics: Anti-Bacterial Agents; Cholera; Humans; Infusions, Parenteral; Pakistan; Statistics as Topic; Tetracycline

Topics: Anti-Bacterial Agents; Chloramphenicol; Cholera; Colistin; Humans; Kanamycin; Pharmacology; Tetracycline; Vibrio; Vibrio cholerae

Topics: Biomedical Research; Cholera; Diarrhea; Humans; India; Leprosy; Research; Tetracycline; Water-Electrolyte Balance

Topics: Anti-Bacterial Agents; Biomedical Research; Cholera; Drug Therapy; Humans; India; Tetracycline

Topics: Anti-Bacterial Agents; Biochemical Phenomena; Cholera; Humans; Metabolism; Protein Synthesis Inhibitors; Tetracycline