Cholera antibiotic treatment

When the diarrhea is not viral (Noro formerly known as Norwalk virus) or protozoal Entamoeba) or caused by a toxin (shell-flsh poisoning) it is often caused by either Salmonella, Shigella, Campylobacter or Yersinia species. In some countries there is a high prevalence of Vibrio cholerae - GTI causing severe watery diarrhea. Clostridium difficile enterocolitis is related to prior antibiotic treatment but also observed during chemotherapy. 

Bacterial infections are the other common neglected diseases. They comprise leprosy and trachoma, which are controlled by antibiotic treatments, Buruli ulcer, managed by surgery and antibiotics, cholera, caused by Vibrio cholerae living in contaminated drinking water, and for which antibacterials and isotonic fluid replacement therapy are recommended. 

Antibiotic LL-E19020a and LL-E19020P are described as useful agents for the treatment of chronic respiratory disease, fowl cholera, and necrotic enteritis in birds (76) and as anthelmintics in monogastric and mminant animals (28). 

The cornerstone of cholera treatment is fluid replacement. Without treatment, the case-fatality rate for severe cholera is approximately 50%. For cholera, rice-based ORT is better than glucose-based ORT because it reduces the number of stools.21 Patients with significant disease should receive a short antibiotic course, 1 to 3 days, to shorten the duration of illness and decrease the number of stools. Doxycycline 300 mg once daily is the drug of choice. Other antibiotics shown to be effective include erythromycin, azithromycin, trimethoprim-sulfamethoxazole, and ciprofloxacin.2 Antibiotic resistance has been documented in V cholerae since 1977.2 Antibiotic prophylaxis is not warranted. 

Treatment — Because of the severe dehydration caused by cholera infection, the most important therapy is fluid and electrolyte replacement. Many antibiotics are effective against V. cholerae, including tetracycline, doxycycline, ciprofloxacin, and erythromycin.3... 

Novobiocin (Fig. 3.9) is a narrow-spectrum antibiotic with antibacterial activity against many gram-positive pathogens. It is frequently used, in combination with penicillin, for treatment of bovine mastitis by intramammary infusion of 200 mg/ quarter in two quarters, and to control fowl cholera and staphylococcal infections in chickens and turkeys at a level of 200-350 g/ton in feed. 

Cholera results from an intestinal infection with the pathogenic bacterium Vibrio choleras that causes a debilitating, and even deadly, diarrhea. Successful treatment of cholera requires effective rehydration with solutions of glucose and salts (Kaper et ai, 1995). Administration of antibiotics decreases the duration of disease (Kaper et a/., 1995) vaccines are only partially effective. Koch, who first described Vibrio cholerae as the causative agent of cholera, suggested that it was a toxin-mediated disease (Koch, 1884). Over a half-century later, the existence of cholera toxin (CT) was demonstrated in cell-free culture filtrates (De, 1959 Dutta eta/., 1959) a decade later, purification of the protein toxin was achieved (Finkelstein and LoSpalluto, 1969). 

Originally named Mixture Cholera Infantum, the popular pink medicine now used for upset stomachs was created to combat cholera. This mixture, whose active ingredient was bismuth subsalicylate (CyH56104), proved effective in treating the nausea and vomiting associated with infant cholera. However, it could not cure the disease itself Nonetheless, the product became a wide success. As science advanced and doctors realized that cholera was contracted from bacteria (which could be treated with antibiotics), bismuth subsalicylate found its way into medical treatments for a variety of other stomach problems, including heartburn, indigestion, and ulcers. 

In the past few centuries, engineering and medicine have all but eliminated some diseases that previously were major threats. Examples are smallpox, typhoid, cholera, bubonic plague, diphtheria, tuberculosis, and poho. Medicine has contributed vaccinations, improved treatments, and the use of antibiotics. Engineering contributed sanitation systems to manage human and other waste and to prevent the spread of diseases and illnesses by treating water. 

Tetracyclines a group of antibiotics from various Streptomyces spp. T. contain four linearly fused six-membered rin individual T. differ according to the nature of substituents (Fig. and Table). T. inhibit protein biosynthesis by preventing the binding of ami-noacyl-tRNA to ribosomes. Next to the penicillins, T. were one of the most widely used antibiotics, particularly in the treatment of bronchitis, pneumonia, bile duct and urinary infections, plague and cholera. They are also widely employed as additives in animal feed-stuffs. On account of side reactions and increasing resistance of bacteria to T. their use is declining. 

For large outbreaks, oral rehydration solutions (ORS) are useful. Standardised World Health Organization (WHO) ORS sachets are available although a home-made version can be produced by adding 8 level teaspoons of table sugar and 1 level teaspoon of table salt to 1 litre of water. Antibiotic therapy can be useful for cholera treatment but does not shorten the disease course. Doxycycline 300 mg p.o. as a stat dose, or ciprofloxacin 250 mg p.o. b.d. for 3 days is recommended. Cryptosporidium infections are self-limiting and effective treatment is strictly supportive. 

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