Single-dose quinolone treatment in acute gastroenteritis

Area of Science:

• Infectious Diseases
• Gastroenterology
• Pharmacology

Background:

• Acute bacterial gastroenteritis (ABGE) is a significant cause of severe diarrhea in Israel, particularly during warmer months.
• Existing research on empiric antibiotic therapy for gastroenteritis is often based on older data with less rigorous diagnostic criteria and lengthy treatment durations.
• This study addresses the need for updated evidence on antibiotic efficacy in managing severe ABGE.

Purpose of the Study:

• To evaluate the overall effectiveness of antibiotic therapy for relatively severe ABGE.
• To assess the efficacy of different quinolone antibiotics in treating ABGE.
• To compare the outcomes of various antibiotic treatment regimens, including single-dose versus multi-day therapy.

Main Methods:

• A randomized controlled trial was conducted involving patients hospitalized with severe gastroenteritis between June and October 2002-2004.
• Participants were assigned to either supportive treatment only or antibiotic treatment with ofloxacin or levofloxacin (single dose or BID for 5 days).
• Symptom duration and resolution were assessed via patient interviews one week post-treatment.

Main Results:

• Antibiotic treatment group (ATG) showed faster resolution of abdominal pain (1.3 days earlier), vomiting (1.0 day earlier), and diarrhea (0.8 days earlier) compared to the supportive treatment group (STG).
• No significant differences were observed in fever abatement between the groups.
• Quinolone type and single-dose versus 5-day regimens did not yield significant differences in symptom resolution.

Conclusions:

• Antibiotic therapy effectively shortens symptom duration in patients with relatively severe gastroenteritis.
• Single-dose antibiotic treatment is a cost-effective and equally effective alternative to a 5-day regimen for ABGE.