Efficacy of tetracycline in the treatment of cholera due to vibrio cholerae O139

Abstract

Objective: Evaluate the effectiveness of tetracycline in the treatment of acute watery diarrhoea due to V. cholerae 0139. Methods: A randomized placebo-controlled double-blind clinical trial was carried out during September through November 1993. Fory-three males with severe cholera (22 placebo and 21 tetracycline group) attending the ICDDR,B's hospital in Dhaka, Bangladesh were studied. Patients were randomized to receive either capsule tetracycline 500 mg six hourly for three days or an identical placebo. Results: Results showed that stool weights were similar in two groups during the first 24 hours (drug 8,437 ± 5,601 g and placebo 8,767 ± 5,164 g, p=0.67). During the second 24 hours, there was a significant reduction of stool weight in the tetracycline group compared to placebo group (1,394 ± 1,512 g vs. 4,519 * 3,574 g, p=0.0012). During the 3rd 24 hours, the difference of stool weight was more striking (drug 560 ± 1,010 g, placebo 3,587 ± 2,791 g, p=0.0001). Significant difference was also observed in the total weights of stool between start of treatment and end of diarrhoea (drug 9,527 ± 6,863 g and placebo 18,185 ± 11,695 g, p=0.015) The mean duration (h) of diarrhoea was reduced by 58% (32 ± 17 h vs. 77 ± 38 h, p=0.010). Tetracycline significantly reduced the faecal positivity rate of V. cholerae O139 at 48 hours (76% vs. 01%, p=<0.001). Tetracycline also reduced total amount of intravenous fluid required compared to placebo (drug 8,219 ± 4,165 ml and placebo 12,019 ± 8,401 ml, p=0.014). Conclusions: These results suggest that tetracycline is an effective drug for the treatment of acute watery diarrhoea due to V. cholerae 0139.