Effective treatment of cholera in children

Cholera is a major public-health problem, with children being the mostaffected. It commonly occurs in areas of poor hygiene and sanitation and may spread as an epidemic in areas of overcrowding, famine and flooding. The incidence of the disease is very high in India and other countries of South East Asia.Effective single-dose antimicrobial treatment regimens have been identified only for adults. According to a new study, single-dose azithromycin is as effective for treatment of cholera in children as standard erythromycin therapy. Researchers from Clinical Sciences Division, International Centre For Diarrhoeal Disease Research (ICDDR), Bangladesh studied 128 severely dehydrated children (age 1-15 years) with cholera, treated at one of two treatment centres in Bangladesh in 1999. The aim of this study was to compare the efficacy of azithromycin and erythromycin regimens in the treatment of children. Children were assigned single-dose azithromycin or, alternatively, erythromycin given every 6 hours for 3 days. Patients stayed in hospital for 5 days. The outcome was cessation of watery diarrhoea within 48 hours and absence of Vibrio cholerae from cultures of stool or rectal swab samples after the second day of study.Treatment was clinically successful in 48 (76%) patients who receivedazithromycin and 39 (65%) who received erythromycin. Patients treated with azithromycin had a shorter duration of diarrhoea. They concluded that single-dose azithromycin is as effective for treatment of cholera in children as standard erythromycin therapy, and is associated with less vomiting.