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[Loperamide for acute infectious diarrhoea].

Joeri A J Douma1, Yvo M Smulders

  • 1VU medisch centrum, afd. Interne Geneeskunde, Amsterdam.

Nederlands Tijdschrift Voor Geneeskunde
|August 7, 2015
PubMed
Summary

Physicians can safely prescribe loperamide for infectious diarrhea, including traveler's diarrhea. Clinical trials show loperamide effectively reduces diarrhea frequency and duration without serious complications in most adults.

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Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Pharmacology

Background:

  • Physician hesitancy exists regarding loperamide for infectious diarrhea due to safety concerns.
  • Evidence from large randomized trials indicates positive effects of loperamide, alone or with antibiotics.
  • International guidelines increasingly support loperamide for infectious diarrhea management, excluding dysentery.

Purpose of the Study:

  • To evaluate the safety and efficacy of loperamide in treating acute infectious diarrhea.
  • To address physician concerns about potential adverse effects of loperamide.
  • To inform clinical practice regarding loperamide use in traveler's and community-acquired diarrhea.

Main Methods:

  • Review of large randomized controlled trials on loperamide use.
  • Analysis of loperamide's efficacy in reducing diarrhea frequency and duration.
  • Assessment of loperamide's safety profile, including adverse events.

Main Results:

  • Randomized trials demonstrate beneficial effects of loperamide, contrary to initial fears.
  • Loperamide is effective as monotherapy or adjunct to antibiotics in immunocompetent adults.
  • No increased risk of severe complications was observed when used appropriately.

Conclusions:

  • Loperamide is a safe and effective treatment for acute infectious diarrhea in immunocompetent adults.
  • It can be used for traveler's diarrhea and community-acquired diarrhea without severe comorbidities.
  • Caution is advised in cases of dysentery, but loperamide may still be considered.

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