Oral maintenance therapy for cholera patients in all age groups

Abstract

56 children and 50 adults were studied to determine the effectiveness of an oral (or nasogastric) therapy with a glucose-electrolyte solution for treating cholera patients. The development of this inexpensive regimen is described. The therapy has the advantages of being cheap, not requiring sterile conditions, and having wide availability in endemic areas. The oral solution contained the following ions (as milliequivalents per liter of water): Na+, 120 K+, 25; CO2-, 48; CL-, 97; and glucose at 110 mmol/liter. Patients received nothing orally except the solution and a 5-day course of tetracycline (dosed according to body weight). The oral (or nasogastric) therapy was used as a supplement when patients arrived in shock, at which time intravenous infusion was used to begin rehydration; patients with milder cholera cases were given only the oral therapy, with much success. All children were maintained in a positive balance with the oral (or nasogastric) solution after correction of shock by intravenous rehydration, and the mean volume of oral solution required by the 56 children was 6 liters. In field trials, 80% of the patients were in positive net intestinal balance by 6 hours after initiation of oral therapy. Adults studied to determine in the 25 mEq potassium/liter solution was safe showed that after administration adult plasma potassium levels were normal.