A single dose of ciprofloxacin reduces the duration of diarrhea among service members deployed in Africa - 05/03/23
, S. Sicard b, J. Desplans b, A. Mayet b, F. Simon a, L. Aigle c, H. Savini a, T. Coton d, C. Marimoutou bTAMIDOPEX team1
Highlights |
• | Diarrhea is the most common medical event among French service members deployed overseas. |
• | A single early dose of one gram of ciprofloxacin significantly reduces the duration of uncomplicated non-invasive diarrhea by 32.5 % and increases the total cure rate at 72 hours (OR = 5.7). |
• | Such probabilistic antibiotic treatment for mild or moderate diarrhea (i.e., neither dysenteric nor incapacitating diarrhea) must be limited to operational conditions to prevent the potential emergence of antibiotic resistance (not for common travelers) and adverse events. |
• | No adverse events of medication were observed during the clinical trial. |
Abstract |
Objectives |
To assess the effectiveness of the adjunction of a one-gram single dose of ciprofloxacin to a symptomatic treatment for the early treatment of uncomplicated diarrhea during military operations of the French service members in Africa.
Patients and methods |
This phase IV, multicentric, randomized, open-label, controlled trial was conducted in Chad, Mali, and in Central African Republic. A total of 267 French service members having at least one loose stool in the previous 24 hours were enrolled from May 2015 to June 2016. Participants were randomized to receive ciprofloxacin 1 g and a symptomatic treatment (racecadotril 100 mg three times a day and ad libidum oral rehydration solution) or a symptomatic treatment alone. The primary outcome was the duration of the diarrhea. Secondary outcomes were evaluated at the 72-hour endpoint and included recovery status, number of loose stools, frequency and duration of associated symptoms and safety of treatments.
Results |
Among 267 participants, 242 completed the trial. Participants receiving ciprofloxacin and a symptomatic treatment (n = 124) were significantly more likely to be cured at the endpoint than those who only received a symptomatic treatment (118): 94.4 % versus 74.6 % (OR = 5.7; 95 %CI: [2.4–13.6]; p < 10-3). The antibiotic therapy reduced the average diarrhea duration by 30 % (p = 10-4). Fever at inclusion was associated with a longer episode (HR = 0.61; 95 %CI: [0.41–0.89]; p = 0.012). No adverse event of medications was reported.
Conclusion |
A single dose of ciprofloxacin was effective and safe in treating uncomplicated diarrhea among service members in Africa.
Le texte complet de cet article est disponible en PDF.Keywords : Ciprofloxacin, Military medicine, Randomized controlled trial, Traveler's diarrhea
Plan
Vol 53 - N° 2
Article 104643- mars 2023 Retour au numéro
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