Comparison of the efficacy of a single-dose ciprofloxacin and of a single-dose doxycycline in the treatment of cholera

Abstract

Objective: Compare the efficacy of a single 1 g dose of ciprofloxacin with that of a single 300 mg dose of doxycycline in the treatment of cholera due to V. cholerae 0139. Methods: More than 100,000 diarrhoea patients are seen annually at the ICDDR,B's Dhaka-based hospital, and the Clinical Research and Service Centre. Cases were selected from these patients. Of 129 evaluable adult males with severe diarrhoea due to V. cholerae 0139, fifty-nine were randomly assigned to receive ciprofloxacin and 70 to receive doxycycline. Results: Treatment was considered to be clinically successful in 54 (91.5%) and 64 (91.4%) of the patients in the ciprofloxacin and doxycycline group respectively. However, the difference was not statistically significant. Similarly, the total volumes of watery stool during the entire period of the study were comparable in the treatment groups. However, only I (1.7%) patient in the ciprofloxacin group had bacteriologic failure compared to 15 (21.4%) patients in the doxycycline group (p=0.002). ConciusisnsT Efficient management of dehydration remains the cornerstone in the management of patients with cholera. However, treatment with effective antimicrobial agents is useful in significantly shortening the duration of diarrhoea and the volume of watery stools, and in shortening the duration of faecal excretion of the pathogen. From this study, it is concluded that a single L g dose of ciprofloxacin is as effective as a single 300 mg dose of doxycycline in terms of clinical response, and that ciprofloxacin is more efficient in eradicating V. cholerae from faeces.