The prophylaxis of travellers' diarrhoea; a double blind placebo controlled trial of ciprofloxacin during a Himalayan expedition

Parry, Huw; Howard, Anthony; Galpin, O. P.; Hassan, Saddam

doi:10.1016/s0163-4453(94)92393-0

Cited by 13 publications

(12 citation statements)

References 3 publications

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“…The study by Parry et al . was not included in the meta-analysis because it did not define TD [29], and the study by Taylor et al . was a human experimental challenge study and thus was not conducted in a field efficacy setting [32].…”

Section: Resultsmentioning

confidence: 99%

“…In a letter to the editor, Parry et al . described a small, double-blind, randomized, placebo-controlled trial of 250 mg of ciprofloxacin compared to placebo in a group of British mountaineers trekking in the Himalayas [29]. The primary end point was not a case definition of TD, but rather a decision by the expedition medical officer to break the code and to stop the trial medication.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of rifaximin and fluoroquinolones in preventing travelers’ diarrhea (TD): a systematic review and meta-analysis

et al. 2012

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BackgroundRecent developments related to a safe and effective nonabsorbable antibiotic, rifaximin, and identification of postinfectious irritable bowel syndrome as a frequent sequela call for a need to reconsider the value of primary prevention of traveler’s diarrhea (TD) with antibiotics.MethodsRandomized, placebo-controlled, double-blind studies evaluating the effectiveness and safety of rifaximin or a fluoroquinolone chemoprophylaxis against TD were pooled using a random effects model and assessed for heterogeneity.ResultsThe nine studies (four rifaximin and five fluoroquinolone) included resulted in pooled relative risk estimates of 0.33 (95% CI = 0.24–0.45, I2 = 3.1%) and 0.12 (95% CI = 0.07–0.20, I2 =0.0%), respectively. Similar rates of treatment emergent adverse events were found between antibiotic and placebo groups.ConclusionsThis meta-analysis supports the effectiveness of antibiotics in preventing TD. However, further studies that include prevention of secondary chronic health outcomes among travelers to different geographic regions, and a formal risk-benefit analysis for antibiotic chemoprophylaxis, are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Effectiveness of rifaximin and fluoroquinolones in preventing travelers’ diarrhea (TD): a systematic review and meta-analysis

et al. 2012

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“…Rifaximin (a nonabsorbable antibiotic) is effective, as is bismuth subsalicylate or a fl uoroquinolone (such as ciprofl oxacin) [ 72 ]. Treatment consists of a single dose of ciprofl oxacin (750 mg), or a 3-day course of rifaximin, or other appropriate antibiotic [ 73 ].…”

Section: Short-term Visitorsmentioning

confidence: 99%

Gastrointestinal Function

Hamad¹,

Travis²

2013

High Altitude

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“…Since the 1980s, several studies have demonstrated the preventive efficacy of neomycin [13], doxycycline [14], trimethoprim-sulfamethoxazole (TMP-SMX) [15] and fluoroquinolones [16] in reducing the incidence rate of TD in different parts of the world. A recent investigation [17] performed on US students traveling to Mexico did show a remarkable efficacy of the poorly absorbed antibiotic, rifaximin, thus confirming the effectiveness of ‘topical’ antimicrobials []for review, see [18].…”

Section: Prevention Of Traveler’s Diarrheamentioning

confidence: 99%

Prevention and Treatment of Traveler’s Diarrhea

et al. 2006

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Diarrhea, mostly due to bacterial infection of the gut, is the most frequent health complaint in the international traveler, affecting 20–70% of the traveling population depending on the destination and other factors. It is usually benign and self-limiting in nature, but symptoms may occasionally be distressing causing modifications of normal activities and sometimes confinement to bed or hospitalization. Prevention of traveler’s diarrhea should ideally be based on dietary restrictions, but experience shows that this target is extremely difficult to achieve. Antibiotic chemoprophylaxis should be restricted to selected groups of travelers at risk of severe complications of diarrhea or when diarrhea-driven alterations of planned activities are highly undesirable (crit- ical trips). The effectiveness of alternative prophylactic approaches, such as vaccination or the use of probiotics, still awaits confirmation. Treatment of mild diarrheal cases without intestinal symptoms may be limited to rehydration with or without antimotility agents. When antibiotic therapy is considered, non-absorbable antibiotics, such as rifaximin, may be considered a valid alternative to systemic antibiotics to treat uncomplicated cases, leaving fluoroquinolones and/or azithromycin for use in more severe cases or when invasive pathogens are suspected. Indeed, therapeutic use of doxycycline and trimethoprim-sulfamethoxazole (TMP-SMX) is limited by widespread resistance of many enteropathogens. The addition of loperamide or other antimotility agents usually provides symptom relief and further shortens the duration of illness and may be therefore safely adopted in the healthy adult unless dysentery is present.

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The prophylaxis of travellers' diarrhoea; a double blind placebo controlled trial of ciprofloxacin during a Himalayan expedition

Cited by 13 publications

References 3 publications

Effectiveness of rifaximin and fluoroquinolones in preventing travelers’ diarrhea (TD): a systematic review and meta-analysis

Effectiveness of rifaximin and fluoroquinolones in preventing travelers’ diarrhea (TD): a systematic review and meta-analysis

Gastrointestinal Function

Prevention and Treatment of Traveler’s Diarrhea

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