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Ciprofloxacin or Trimethoprim-Sulfamethoxazole as Initial Therapy for Travelers' Diarrhea: A Placebo-Controlled, Randomized Trial

CHARLES D. ERICSSON, M.D.; PHILIP C. JOHNSON, M.D.; HERBERT L. DUPONT, M.D.; DONNA R. MORGAN, Ph.D.; JO ANN M. BITSURA, M.P.H.; and F. JAVIER DE LA CABADA, M.D.
[+] Article and Author Information

Grant support: by a grant from Miles Pharmaceuticals. Presented in part on 29 September 1986 at the 26th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, Louisiana.

▸Requests for reprints should be addressed to Charles D. Ericsson, M.D.; Program in Infectious Diseases and Clinical Microbiology, The University of Texas Medical School at Houston, P.O. Box 20708, 6431 Fannin Street; Houston, TX 77030.


Houston, Texas; and Guadalajara, Jalisco, Mexico


©1987 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1987;106(2):216-220. doi:10.7326/0003-4819-106-2-216
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The efficacy of ciprofloxacin was compared with that of trimethoprim-sulfamethoxazole in a placebo-controlled trial of the 5-day treatment of acute diarrhea among 181 adults recently arrived in Guadalajara, Mexico. Both antimicrobial agents were significantly (p < 0.0001) more efficacious than placebo in the treatment of diarrhea, with the average duration of diarrhea being 29, 20, and 81 hours, respectively, in the ciprofloxacin, trimethoprim-sulfamethoxazole, and placebo treatment groups. The antimicrobial agents were also more efficacious than placebo in treating diarrhea caused by enterotoxigenic Escherichia coli, invasive enteropathogens, and unknown pathogens. Both antimicrobials were effective in treating mild-to-moderate and moderate-to-severe disease, and both were well tolerated. Ciprofloxacin appears to be a logical alternative to trimethoprim-sulfamethoxazole in the initial treatment of acute travelers' diarrhea.

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