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Single dose azithromycin versus ciprofloxacin for cholera in children: a randomized controlled trial

Jaya Shankar Kaushik1, Piyush Gupta, M Ma Faridi

  • 1Department of Pediatrics University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India. jayashankarkaushik@gmail.com

Indian Pediatrics
|July 7, 2009
PubMed

Insights

Single dose azithromycin is more effective than ciprofloxacin for treating childhood cholera, leading to faster recovery and reduced fluid needs. This study highlights azithromycin as a superior treatment option for pediatric cholera cases.

Area of Science:

  • Pediatric infectious diseases
  • Antimicrobial therapy
  • Gastroenterology

Background:

  • Cholera remains a significant public health concern, particularly in pediatric populations.
  • Effective antibiotic treatment is crucial for managing cholera and preventing complications.
  • Comparing single-dose antibiotic regimens can optimize treatment protocols.

Purpose of the Study:

  • To evaluate and compare the clinical and bacteriological efficacy of single-dose azithromycin versus ciprofloxacin in children diagnosed with cholera.
  • To determine the superiority of one antibiotic over the other in terms of treatment outcomes.

Main Methods:

  • A randomized, open-label clinical trial was conducted with 180 children aged 2-12 years presenting with severe dehydration and confirmed Vibrio cholerae infection.
  • Participants received either a single dose of azithromycin (20 mg/kg) or ciprofloxacin (20 mg/kg).
  • Clinical success was defined as diarrhea resolution within 24 hours, and bacteriological success as cessation of Vibrio cholerae excretion by day 3.

Main Results:

  • Azithromycin demonstrated significantly higher clinical success rates (94.5%) compared to ciprofloxacin (70.7%) (P<0.001).
  • Bacteriological success was nearly complete in both groups, with a trend favoring azithromycin (100% vs 95.5%, P=0.06).
  • Children treated with azithromycin experienced shorter diarrhea duration, reduced Vibrio cholerae excretion time, and lower intravenous fluid requirements.

Conclusions:

  • Single-dose azithromycin is clinically and bacteriologically superior to single-dose ciprofloxacin for the treatment of cholera in children.
  • Azithromycin offers advantages in terms of faster symptom resolution and reduced healthcare resource utilization.
  • The findings support azithromycin as a preferred first-line treatment for pediatric cholera.
Abstract

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