title: Azithromycin found to be comparable to levofloxacin for the treatment of US travelers with acute diarrhea acquired in Mexico.
abstract: Increased drug resistance among enteropathogens is an emergent problem in travelers' diarrhea. This randomized, double-blind trial was conducted in Guadalajara, Mexico, during the summers of 1999-2001 to compare azithromycin with levofloxacin for the treatment of travelers' diarrhea. A total of 217 US adults were randomized to receive a single oral dose of azithromycin (1000 mg; 108 persons) or levofloxacin (500 mg; 109 persons), with a follow-up period of 4 days. Three patients in each group dropped out of the study. The median time between initiation of therapy and passage of the last unformed stool (azithromycin group, 22.3 h; levofloxacin group, 21.5 h) and the number of unformed stools passed during the 4-day follow-up period (azithromycin group, 6.5; levofloxacin group, 5.5) were similar. Treatment failure occurred in 10 patients (9.5%) receiving azithromycin and 8 patients (7.5%) receiving levofloxacin. Possible minor, self-limiting adverse events occurred in 57 patients in each treatment group. Azithromycin was found to be a safe and effective alternative to levofloxacin for the treatment of acute travelers' diarrhea in US adult travelers to Mexico.
authors.affiliation: Center for Infectious Diseases, University of Texas-Houston School of Public Health and Medical School, Houston, Texas, USA.
authors.forename: Javier A
authors.initials: JA
authors.lastname: Adachi
authors.forename: Charles D
authors.initials: CD
authors.lastname: Ericsson
authors.forename: Zhi-Dong
authors.initials: ZD
authors.lastname: Jiang
authors.forename: Margaret W
authors.initials: MW
authors.lastname: DuPont
authors.forename: Francisco
authors.initials: F
authors.lastname: Martinez-Sandoval
authors.forename: Charles
authors.initials: C
authors.lastname: Knirsch
authors.forename: Herbert L
authors.initials: HL
authors.lastname: DuPont
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use*; D003967:Diarrhea / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008800:Mexico; D015242:Ofloxacin / Q000627:therapeutic use; D014195:Travel
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D064704:Levofloxacin; D017963:Azithromycin; D015242:Ofloxacin