Biweekly prophylactic doxycycline for travelers' diarrhea

A double-blind study to determine the efficacy of biweekly oral doxycycline in the prevention of travelers' diarrhea was conducted among 46 Peace Corps volunteers during their first six weeks in Honduras. The volunteers took either 100 mg of doxycycline per dose or a placebo for three weeks and were observed for an additional three weeks. There was no significant difference in the number of persons with travelers' diarrhea in the two groups (eight of 24 in the doxycycline group and 10 of 22 in the placebo group) in the three weeks when the drug was taken. However, significantly fewer episodes (P less than 0.05) of travelers' diarrhea occurred in the doxycycline group than in the placebo group at the end of the second, third, and fourth weeks. Enterotoxigenic Escherichia coli (ETEC) was the most common pathogen identified. ETEC from 13 (62%) of 21 stool samples were resistant to doxycycline. Biweekly doxycycline was only marginally effective in preventing travelers' diarrhea and did not prevent diarrhea secondary to doxycycline-resistant ETEC.