title: Randomized control trials using a tablet formulation of hyperimmune bovine colostrum to prevent diarrhea caused by enterotoxigenic Escherichia coli in volunteers.
abstract: OBJECTIVE
  Enterotoxigenic Escherichia coli (ETEC) is the leading cause of travelers' diarrhea. The aim of this study was to investigate the ability of a powdered extract of hyperimmune bovine colostrum to protect against diarrhea in volunteers challenged with ETEC.
  
  
  METHODS
  Tablets were manufactured from a colostrum extract from cattle immunized with 14 ETEC strains, including serogroup O78. Two separate randomized, double-blind, placebo-controlled trials involving 90 healthy adult volunteers were performed to investigate the ability of different tablet formulations to protect against diarrhea following an oral challenge with an O78 ETEC strain.
  
  
  RESULTS
  The first study with 30 participants evaluated the efficacy of tablets, containing 400 mg of colostrum protein, taken thrice daily with bicarbonate buffer. This regimen conferred 90.9% protection against diarrhea in the group receiving the active preparation compared with the placebo group (p = 0.0005). The second study examined the efficacy of tablets containing 400 mg colostrum protein given with buffer (83.3% protection; p = 0.0004) or without buffer (76.7% protection; p = 0.007), and tablets containing 200 mg colostrum protein given without buffer (58.3% protection; p = 0.02), compared with placebo. The difference between buffered and unbuffered treatments was not significant (p > 0.1).
  
  
  CONCLUSIONS
  Active tablet formulations were significantly more effective than placebo in protecting volunteers against the development of diarrhea caused by ETEC. These results suggest that administration of a tablet formulation of hyperimmune bovine colostrum containing antibodies against ETEC strains may reduce the risk of travelers' diarrhea.
authors.affiliation: Department of General and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Wlodzimierz
authors.initials: W
authors.lastname: Otto
authors.forename: Boguslaw
authors.initials: B
authors.lastname: Najnigier
authors.forename: Teodor
authors.initials: T
authors.lastname: Stelmasiak
authors.forename: Roy M
authors.initials: RM
authors.lastname: Robins-Browne
mesh_terms: D000328:Adult; D000818:Animals; D000907:Antibodies, Bacterial / Q000008:administration & dosage / Q000627:therapeutic use*; D002021:Buffers; D002417:Cattle; D003126:Colostrum / Q000276:immunology*; D003967:Diarrhea / Q000382:microbiology* / Q000517:prevention & control*; D004311:Double-Blind Method; D054307:Enterotoxigenic Escherichia coli / Q000276:immunology*; D004927:Escherichia coli Infections / Q000150:complications*; D006801:Humans; D017693:Sodium Bicarbonate / Q000008:administration & dosage; D013607:Tablets
chemical_list: D000907:Antibodies, Bacterial; D002021:Buffers; D013607:Tablets; D017693:Sodium Bicarbonate