Norfloxacin compared to trimethoprim/sulfamethoxazole for the treatment of travelers' diarrhea among U.S. military personnel deployed to South America and West Africa.
A randomized treatment trial of travelers' diarrhea was carried out among U.S. military personnel participating in routine exercises in several port cities in South America and West Africa. A 5-day, twice daily course of either norfloxacin (400 mg) or trimethoprim/sulfamethoxazole (TMP/SMX, 160/800 mg) was given to 142 volunteers. At the end of 5 days of treatment, diarrhea had resolved in 100% of 73 patients receiving norfloxacin and 97.1% (67/69) receiving TMP/SMX. A probable bacterial pathogen was determined in 44% of 142 subjects: 49% of the norfloxacin group and 39% of the TMP/SMX group. The most common pathogens detected were enterotoxigenic Escherichia coli in 20% of cases and rotavirus in 15%. Resistance to TMP/SMX was present in 20 (27%) bacterial isolates, while no resistance to norfloxacin was found. Eight of 10 patients in the TMP/SMX treatment group who had TMP/SMX-resistant bacterial enteropathogens improved clinically. Both norfloxacin and TMP/SMX were clinically effective in the treatment of travelers' diarrhea in this military population.
Thornton
S A
SA
Department of Infectious Diseases, U.S. Naval Medical Research Institute, Bethesda, MD.
Wignall
S F
SF
Kilpatrick
M E
ME
Bourgeois
A L
AL
Gardiner
C
C
Batchelor
R A
RA
Burr
D H
DH
Oprandy
J J
JJ
Garst
P
P
Hyams
K C
KC
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000354:Africa, Western; D001424:Bacterial Infections / Q000188:drug therapy; D003967:Diarrhea / Q000188:drug therapy*; D004927:Escherichia coli Infections / Q000188:drug therapy; D005243:Feces / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D009643:Norfloxacin / Q000627:therapeutic use*; D013020:South America; D011795:Surveys and Questionnaires; D014195:Travel; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*; D014481:United States; D014777:Virus Diseases / Q000188:drug therapy
D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D009643:Norfloxacin