The efficacy of bismuth subsalicylate in the treatment of acute diarrhoea and the prevention of persistent diarrhoea.
A controlled, randomized, double-blind study in Bangladeshi children (ages 4-36 mo) with acute diarrhoea was undertaken to determine whether bismuth subsalicylate (BSS) would prevent the development of persistent diarrhoea (PD) in young children. The children were randomized to two groups: 226 were given liquid oral BSS, (as Pepto-Bismol), 100 mg/kg/d for 5 d; 225 were given placebo of identical appearance. On admission to the study, the two groups were comparable both clinically and microbiologically. Rotavirus was found in 56% of all the children, and enterotoxigenic E. coli in 31% of a subsample studied. Children treated with BSS had less severe and less prolonged illness than those treated with placebo (p = 0.057). There was, however, no difference in the development of PD between the two groups (8% and 11%). Unexpectedly, patients treated with BSS gained significantly more weight (2.3%) than those treated with placebo (0.5%; p < 0.001) during the course of the study. No toxicity of BSS was detected.


CONCLUSIONS
Treatment with BSS had a modest therapeutic effect on acute diarrhoea, as has been previously demonstrated, but with no suggestion of a therapeutic effect on the prevention of persistent diarrhoea in this group of patients.
Chowdhury
H R
HR
Public Health Sciences Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Yunus
M
M
Zaman
K
K
Rahman
A
A
Faruque
S M
SM
Lescano
A G
AG
Sack
R B
RB
D000208:Acute Disease; D001729:Bismuth / Q000627:therapeutic use*; D002675:Child, Preschool; D003967:Diarrhea / Q000188:drug therapy* / Q000517:prevention & control; D004311:Double-Blind Method; D004927:Escherichia coli Infections; D006801:Humans; D007223:Infant; D009942:Organometallic Compounds / Q000627:therapeutic use*; D015532:Rehydration Solutions / Q000627:therapeutic use*; D012192:Retroviridae Infections / Q000188:drug therapy; D012459:Salicylates / Q000627:therapeutic use*
D009942:Organometallic Compounds; D015532:Rehydration Solutions; D012459:Salicylates; C015715:bismuth subsalicylate; D001729:Bismuth