The Experts below are selected from a list of 30 Experts worldwide ranked by ideXlab platform
Charles D. Ericsson - One of the best experts on this subject based on the ideXlab platform.
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Treatment of Travelers’ Diarrhea: Randomized Trial Comparing Rifaximin, Rifaximin Plus Loperamide, and Loperamide Alone
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2007Co-Authors: Herbert L. Dupont, Zhi Dong Jiang, Jaime Belkind-gerson, Pablo C. Okhuysen, Charles D. Ericsson, David B. Huang, Margaret W. Dupont, Javier A. Adachi, F. Javier De La CabadaAbstract:Background & Aims: Antimotility Agents provide rapid temporary relief of acute diarrhea, whereas antibiotics slowly cure the illness. Thus, the combination of an Antimotility Agent and an antibiotic may provide greater therapeutic benefit than either drug alone. This study evaluated the efficacy and safety of rifaximin-loperamide in the treatment of travelers' diarrhea. Methods: Consenting adults with acute diarrhea (≥3 unformed stools in 24 hours with ≥1 symptom of enteric infection) were randomized to receive rifaximin 200 mg 3 times daily for 3 days; loperamide 4 mg initially followed by 2 mg after each unformed stool; or a combination of both drugs using the same dosing regimen. The primary end point was the median time from beginning therapy until passing the last unformed stool. Results: A total of 310 patients completed treatment with rifaximin (n = 102), loperamide (n = 104), or rifaximin-loperamide combination therapy (n = 104). The groups showed demographic similarity. Rifaximin and rifaximin-loperamide significantly reduced the median time until passage of the last unformed stool (32.5 ± 4.14 h and 27.3 ± 4.13 h, respectively) vs loperamide (69 ± 4.11 h; P = .0019). The mean number of unformed stools passed during illness was lower with rifaximin-loperamide (3.99 ± 4.28) compared with rifaximin (6.23 ± 6.90; P = .004) or loperamide alone (6.72 ± 6.93; P = .002). All treatments were well tolerated with a low incidence of adverse events. Conclusions: Rifaximin-loperamide therapy provided rapid symptomatic improvement and greater overall wellness compared with either Agent alone.
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Non-antimicrobial Agents in the prevention and treatment of traveler's diarrhea
2005Co-Authors: Charles D. EricssonAbstract:Among the nonantimicrobial Agents that are available and useful for the prevention of traveler’s diarrhea are bismuth subsalicylate–containing preparations, which can provide a rate of protection of up to 65 % when taken 4 times daily. In one study, the probiotic Lactobacillus GG was found to provide 49 % protection against traveler’s diarrhea, but results with this Agent and other probiotics have been highly variable and geographically inconsistent. Tannin albuminate plus ethacridine lactate provided 36 % protection, but it is not widely available. Among the nonantimicrobial Agents that are available and useful for the treatment of traveler’s diarrhea are bismuth subsalicylate–containing preparations, which reduce the passage of loose stools by 16%–18%. The antisecretory and Antimotility Agent loperamide reduces the passage of loose stools by ∼50 % and has been especially useful, in combination with antimicrobial Agents, in reducing the total duration of posttreatment diarrhea to a matter of hours. The management of traveler’s diarrhea includes the use of Agents that treat symptoms of diarrhea without di-rectly killing the microorganisms that cause the syn-drome [1–3]. These Agents can be organized by their mechanisms of action (tables 1 and 2). One Agent, bis
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single dose ofloxacin plus loperamide compared with single dose or three days of ofloxacin in the treatment of traveler s diarrhea
Journal of Travel Medicine, 1997Co-Authors: Charles D. Ericsson, Herbert L. Dupont, John J MathewsonAbstract:Background: Although the use of the antimicrobial, trimeth oprim-sulfamethoxazole, in combination with the antisecretory and Antimotility Agent, loperamide, has been shown to be efficacious in the treatment of traveler's diarrhea, the use of fluoroquinolone antimicrobials in combination with loperamide has less support in the literature. The present study was designed to compare the efficacy of ofloxacin versus ofloxacin plus loperamide in the treatment of acute traveler's diarrhea. Method: This prospective, randomized, evaluator-blinded treatment trial was conducted in Guadalajara, Mexico, during the summers of 1992–1994. Adults newly arrived in Mexico from the United States who developed acute diarrhea of less than 2 weeks' duration were randomized to receive orally either: A) ofloxacin, 400 mg once; B) ofloxacin, 200 mg twice a day for six doses; or C) ofloxacin, 400 mg once, plus loperamide, 4 mg once followed by 2 mg after each loose stool, not to exceed 16 mg per day, for 3 days. The duration of illness was the number of hours elapsed from the beginning of therapy to the passage of the last unformed stool. Results: Ofloxacin and loperamide were well tolerated. Combination therapy with single dose ofloxacin plus loperamide was significantly more efficacious in reducing the duration of diarrhea than single dose ofloxacin or ofloxacin given for 3 days (p < .00001). Furthermore, combination therapy was more efficacious when enterotoxigenic Escherichia coli (ETEC) was the pathogen (p < .01) or when no pathogen was isolated (p < .001). Sixty-three percent of subjects passed no further unformed stools after the initial doses of combination therapy, and 91% were well by the end of the first 24 hours. Conclusions: The combined use of a single dose of ofloxacin with loperamide is safe and more efficacious in the treatment of traveler's diarrhea than use of ofloxacin alone.
Diemert, David J. - One of the best experts on this subject based on the ideXlab platform.
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Prevention and self-treatment of traveler\u27s diarrhea
Health Sciences Research Commons, 2006Co-Authors: Diemert, David J.Abstract:Of the millions who travel from the industrialized world to developing countries every year, between 20% and 50% will develop at least one episode of diarrhea, making it the most common medical ailment afflicting travelers. Although usually a mild illness, traveler\u27s diarrhea can result in significant morbidity and hardship overseas. Precautions can be taken to minimize the risk of developing traveler\u27s diarrhea, either through avoidance of potentially contaminated food or drink or through various prophylactic measures, including both nonpharmacological and antimicrobial strategies. If diarrhea does develop despite the precautions taken, effective treatment-usually a combination of an antibiotic and an Antimotility Agent-can be brought by the traveler and initiated as soon as symptoms develop. In the future, vaccines-several of which are in the advanced stages of clinical testing-may be added to the list of prophylactic measures. Copyright © 2006, American Society for Microbiology. All Rights Reserved
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Prevention and self-treatment of travelers\u27 diarrhea
Health Sciences Research Commons, 2002Co-Authors: Diemert, David J.Abstract:Of the 50 million people who travel from the industrialized world to developing countries every year, between 20% and 50% will develop at least one episode of diarrhea, making it the most common ailment of travel. Although usually a mild illness, travelers\u27 diarrhea can result in significant morbidity and hardship while overseas. Precautions can be taken to minimize the risk of developing diarrhea. If diarrhea does develop despite precautions, effective treatment, usually a combination of an antibiotic and an Antimotility Agent, can be taken along and started by the traveler at the onset of symptoms
Herbert L. Dupont - One of the best experts on this subject based on the ideXlab platform.
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Treatment of Travelers’ Diarrhea: Randomized Trial Comparing Rifaximin, Rifaximin Plus Loperamide, and Loperamide Alone
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2007Co-Authors: Herbert L. Dupont, Zhi Dong Jiang, Jaime Belkind-gerson, Pablo C. Okhuysen, Charles D. Ericsson, David B. Huang, Margaret W. Dupont, Javier A. Adachi, F. Javier De La CabadaAbstract:Background & Aims: Antimotility Agents provide rapid temporary relief of acute diarrhea, whereas antibiotics slowly cure the illness. Thus, the combination of an Antimotility Agent and an antibiotic may provide greater therapeutic benefit than either drug alone. This study evaluated the efficacy and safety of rifaximin-loperamide in the treatment of travelers' diarrhea. Methods: Consenting adults with acute diarrhea (≥3 unformed stools in 24 hours with ≥1 symptom of enteric infection) were randomized to receive rifaximin 200 mg 3 times daily for 3 days; loperamide 4 mg initially followed by 2 mg after each unformed stool; or a combination of both drugs using the same dosing regimen. The primary end point was the median time from beginning therapy until passing the last unformed stool. Results: A total of 310 patients completed treatment with rifaximin (n = 102), loperamide (n = 104), or rifaximin-loperamide combination therapy (n = 104). The groups showed demographic similarity. Rifaximin and rifaximin-loperamide significantly reduced the median time until passage of the last unformed stool (32.5 ± 4.14 h and 27.3 ± 4.13 h, respectively) vs loperamide (69 ± 4.11 h; P = .0019). The mean number of unformed stools passed during illness was lower with rifaximin-loperamide (3.99 ± 4.28) compared with rifaximin (6.23 ± 6.90; P = .004) or loperamide alone (6.72 ± 6.93; P = .002). All treatments were well tolerated with a low incidence of adverse events. Conclusions: Rifaximin-loperamide therapy provided rapid symptomatic improvement and greater overall wellness compared with either Agent alone.
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single dose ofloxacin plus loperamide compared with single dose or three days of ofloxacin in the treatment of traveler s diarrhea
Journal of Travel Medicine, 1997Co-Authors: Charles D. Ericsson, Herbert L. Dupont, John J MathewsonAbstract:Background: Although the use of the antimicrobial, trimeth oprim-sulfamethoxazole, in combination with the antisecretory and Antimotility Agent, loperamide, has been shown to be efficacious in the treatment of traveler's diarrhea, the use of fluoroquinolone antimicrobials in combination with loperamide has less support in the literature. The present study was designed to compare the efficacy of ofloxacin versus ofloxacin plus loperamide in the treatment of acute traveler's diarrhea. Method: This prospective, randomized, evaluator-blinded treatment trial was conducted in Guadalajara, Mexico, during the summers of 1992–1994. Adults newly arrived in Mexico from the United States who developed acute diarrhea of less than 2 weeks' duration were randomized to receive orally either: A) ofloxacin, 400 mg once; B) ofloxacin, 200 mg twice a day for six doses; or C) ofloxacin, 400 mg once, plus loperamide, 4 mg once followed by 2 mg after each loose stool, not to exceed 16 mg per day, for 3 days. The duration of illness was the number of hours elapsed from the beginning of therapy to the passage of the last unformed stool. Results: Ofloxacin and loperamide were well tolerated. Combination therapy with single dose ofloxacin plus loperamide was significantly more efficacious in reducing the duration of diarrhea than single dose ofloxacin or ofloxacin given for 3 days (p < .00001). Furthermore, combination therapy was more efficacious when enterotoxigenic Escherichia coli (ETEC) was the pathogen (p < .01) or when no pathogen was isolated (p < .001). Sixty-three percent of subjects passed no further unformed stools after the initial doses of combination therapy, and 91% were well by the end of the first 24 hours. Conclusions: The combined use of a single dose of ofloxacin with loperamide is safe and more efficacious in the treatment of traveler's diarrhea than use of ofloxacin alone.
John J Mathewson - One of the best experts on this subject based on the ideXlab platform.
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single dose ofloxacin plus loperamide compared with single dose or three days of ofloxacin in the treatment of traveler s diarrhea
Journal of Travel Medicine, 1997Co-Authors: Charles D. Ericsson, Herbert L. Dupont, John J MathewsonAbstract:Background: Although the use of the antimicrobial, trimeth oprim-sulfamethoxazole, in combination with the antisecretory and Antimotility Agent, loperamide, has been shown to be efficacious in the treatment of traveler's diarrhea, the use of fluoroquinolone antimicrobials in combination with loperamide has less support in the literature. The present study was designed to compare the efficacy of ofloxacin versus ofloxacin plus loperamide in the treatment of acute traveler's diarrhea. Method: This prospective, randomized, evaluator-blinded treatment trial was conducted in Guadalajara, Mexico, during the summers of 1992–1994. Adults newly arrived in Mexico from the United States who developed acute diarrhea of less than 2 weeks' duration were randomized to receive orally either: A) ofloxacin, 400 mg once; B) ofloxacin, 200 mg twice a day for six doses; or C) ofloxacin, 400 mg once, plus loperamide, 4 mg once followed by 2 mg after each loose stool, not to exceed 16 mg per day, for 3 days. The duration of illness was the number of hours elapsed from the beginning of therapy to the passage of the last unformed stool. Results: Ofloxacin and loperamide were well tolerated. Combination therapy with single dose ofloxacin plus loperamide was significantly more efficacious in reducing the duration of diarrhea than single dose ofloxacin or ofloxacin given for 3 days (p < .00001). Furthermore, combination therapy was more efficacious when enterotoxigenic Escherichia coli (ETEC) was the pathogen (p < .01) or when no pathogen was isolated (p < .001). Sixty-three percent of subjects passed no further unformed stools after the initial doses of combination therapy, and 91% were well by the end of the first 24 hours. Conclusions: The combined use of a single dose of ofloxacin with loperamide is safe and more efficacious in the treatment of traveler's diarrhea than use of ofloxacin alone.
David J. Diemert - One of the best experts on this subject based on the ideXlab platform.
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Prevention and Self-Treatment of Traveler's Diarrhea
Clinical Microbiology Reviews, 2006Co-Authors: David J. DiemertAbstract:Of the millions who travel from the industrialized world to developing countries every year, between 20% and 50% will develop at least one episode of diarrhea, making it the most common medical ailment afflicting travelers. Although usually a mild illness, traveler's diarrhea can result in significant morbidity and hardship overseas. Precautions can be taken to minimize the risk of developing traveler's diarrhea, either through avoidance of potentially contaminated food or drink or through various prophylactic measures, including both nonpharmacological and antimicrobial strategies. If diarrhea does develop despite the precautions taken, effective treatment—usually a combination of an antibiotic and an Antimotility Agent—can be brought by the traveler and initiated as soon as symptoms develop. In the future, vaccines—several of which are in the advanced stages of clinical testing—may be added to the list of prophylactic measures.