Controlled clinical trials to a standardised protocol were conducted into the effect of a water-soluble antibiotic on proliferative enteropathy and its causative agent (Lawsonia intracellularis) on commercial pig farms at six sites in four European countries. Clinical signs of the disease and L intracellularis-specific polymerase chain reaction (PCR)-positive pigs were detected in pens of six- to 12-week-old pigs (weighing 5 to 55 kg) immediately before each trial. Matched pens of randomised pigs were either left unmedicated (32 to 59 pigs per trial), or medicated orally with 10 mg/kg of a water-soluble combination of lincomycin and spectinomycin powder (21 and 42 mg, respectively, of antibiotic activity per litre) for either seven days (33 to 61 pigs per trial), or 14 days (33 to 61 pigs per trial), delivered via the drinking water. Investigators did not know which pens received which treatment In most of the affected pigs in each trial, diarrhoea due to L intracellularis resolved within three to seven days after the medication began, whereas most unmedicated pigs remained diarrhoeic for at least 10 days. On average the medicated pigs gained more weight than the unmedicated pigs over the 21-day trial period (P=0.01). In two trials, the absence of L intracellularis after the treatment ended was confirmed by the PCR.