Sacolene in cholera: a double blind randomized controlled trial

Methylated casein (Sacolene), a diarrhoea remedy used in Europe, has shown an antisecretory effect in cholera-induced secretion in animals and benefit in diarrhoea in humans. In this placebo controlled trial Sacolene was evaluated in 78 male adults with severe cholera who, after initial i.v. therapy received Sacolene or placebo, 4 g at start and 2 g 4 hourly until cessation of diarrhoea, along with oral rehydration therapy and repeat i.v. therapy if indicated. No antibiotics were given during the study. The purging rate and diarrhoea duration were similar in the 2 groups. The proportion of patients requiring repeat courses of i.v. therapy in the study group was 46% compared with 69% in controls (i.e. reduced by 23%, p = 0.04). While the severity of purging was not reduced, the proportion of patients requiring repeat i.v. therapy was reduced by Sacolene therapy. The latter finding may indicate some benefit from Sacolene in cholera, though this requires confirmation.