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      Open Clinical Trial on Using Nifuroxazide Compared to Probiotics in Treating Acute Diarrhoeas in Adults

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          Abstract

          Background:

          Nifuroxazide is well known and often used anti-diarrhoeal medicine which has been pushed back from routine practice in recent years and often replaced with probiotics. Even probiotics are accepted and placed in some therapeutic guidelines for diarrhoea treatment, there are no enough evidence for its effectiveness and no comparative efficacy data with nifuroxazide in treatment of acute diarrhea.

          Patients and Methods:

          In open, prospective observational study, the efficacy and safety of nifuroxazide were compared with a probiotic containing lactic acid bacteria in the treatment of acute diarrhoea. A total number of 169 adult patients were included in this study, who administered nifuroxazide in the dose of 200 mg/4 times a day, while they took preparation containing lactic acid bacteria (1,2 x 10 7 live lyophilised lactic-acid bacteria) three times a day for three days.

          Results:

          Mean time to last unformed stool (TLUS) in a group which was treated with nifuroxazide was two days, while it took five days for the stool normalisation in the group using probiotic (p=0.0001).

          Conclusions:

          Orally administered nifuroxazide has demonstrated better efficiency as compared to probiotic in treating acute diarrhoea, and both medicines have shown the same safety and tolerance in this study.

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          Most cited references15

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          Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomised, placebo-controlled trials.

          Sunil Sazawal, Girish Hiremath, Usha Dhingra … (2006)
          To evaluate the evidence for the use of probiotics in the prevention of acute diarrhoea, we did a meta-analysis of the available data from 34 masked, randomised, placebo-controlled trials. Only one trial was community based and carried out in a developing country. Most of the remaining 33 studies were carried out in a developed country in a health-care setting. Evaluating the evidence by types of acute diarrhoea suggests that probiotics significantly reduced antibiotic-associated diarrhoea by 52% (95% CI 35-65%), reduced the risk of travellers' diarrhoea by 8% (-6 to 21%), and that of acute diarrhoea of diverse causes by 34% (8-53%). Probiotics reduced the associated risk of acute diarrhoea among children by 57% (35-71%), and by 26% (7-49%) among adults. The protective effect did not vary significantly among the probiotic strains Saccharomyces boulardii, Lactobacillus rhamnosus GG, Lactobacillus acidophilus, Lactobacillus bulgaricus, and other strains used alone or in combinations of two or more strains. Although there is some suggestion that probiotics may be efficacious in preventing acute diarrhoea, there is a lack of data from community-based trials and from developing countries evaluating the effect on acute diarrhoea unrelated to antibiotic usage. The effect on acute diarrhoea is dependent on the age of the host and genera of strain used.
          Article 0 comments Cited 112 times – based on 0 reviews     Review now
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            Enteropathogens in adult patients with diarrhea and healthy control subjects: a 1-year prospective study in a Swedish clinic for infectious diseases.

            E Ekwall, A Lagergren, A Kärnell … (2000)
            A 1-year prospective study was conducted to identify enteropathogens in adults with diarrhea (n=851) and in healthy control subjects (n=203) by use of conventional laboratory methods. Virulence factor genes for diarrheagenic Escherichia coli were detected by polymerase chain reaction. Enteropathogens were identified in 56% of patients and 16% of control subjects. The isolation rate was 65% for patients with symptoms for 1 pathogen was found in 11% of patients. The most frequent enteropathogens were Campylobacter (13% of patients), Clostridium difficile (13%), enterotoxigenic Escherichia coli (8%), Salmonella (7%), Shigella (4%), Blastocystis hominis (4%), calicivirus (3%), rotavirus (3%), enteroaggregative E. coli (2%), Aeromonas (2%), Giardia intestinalis (2%), Cryptosporidium (2%), and astrovirus (2%). Less frequently isolated (< or =1% of patients) were verotoxigenic E. coli, enteropathogenic E. coli, enteroinvasive E. coli, Entamoeba histolytica/Entamoeba dispar, microsporidia, and adenovirus. Fifty percent of the patients were hospitalized, and 43% needed intravenous fluids. The median duration of diarrhea was 14 days. Clinical features were not helpful for predicting the etiology of diarrhea.
            Article 0 comments Cited 47 times – based on 0 reviews     Review now
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              Rifaximin versus ciprofloxacin for the treatment of traveler's diarrhea: a randomized, double-blind clinical trial.

              F. Martinez-Sandoval, M. DuPont, E Palazzini … (2001)
              Rifaximin is a poorly absorbed rifamycin derivative under investigation for treatment of infectious diarrhea. Adult students from the United States in Mexico and international tourists in Jamaica were randomized to receive either rifaximin (400 mg twice per day) or ciprofloxacin (500 mg twice per day) for 3 days, following a double-blinded model, from June 1997 to September 1998. A total of 187 subjects with diarrhea were studied. Time from initiation of therapy to passage of last unformed stool was comparable for those receiving rifaximin or ciprofloxacin (median, 25.7 hours versus 25.0 hours, respectively). There was no significant difference in the proportion of subjects in the 2 groups with respect to clinical improvement during the first 24 hours (P=.199), failure to respond to treatment (P=.411), or microbiological cure (P=.222). The incidence of adverse events was low and similar in each group. Rifaximin is a safe and effective alternative to ciprofloxacin in the treatment of traveler's diarrhea.
              Article 0 comments Cited 27 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Mater Sociomed
                Journal ID (iso-abbrev): Mater Sociomed
                Title: Materia Socio-Medica
                Publisher: AVICENA, d.o.o., Sarajevo (Bosnia and Herzegovina )
                ISSN (Print): 1512-7680
                ISSN (Electronic): 1986-597X
                Publication date (Print): December 2016
                Volume: 28
                Issue: 6
                Pages: 454-458
                Affiliations
                [1 ]Clinical Pharmacology, Clinical Center University of Sarajevo
                [2 ]Clinic for Infectious Diseases, University Clinical Center Tuzla
                [3 ]Bosnalijek JSC, Sarajevo, Jukiceva 53, 71 000 Sarajevo, Bosnia and Herzegovina
                [4 ]Service for Contagious Diseases and Unclear Febrile Conditions, Cantonal Hospital in Zenica
                Author notes
                Corresponding author: Meliha Mehić, Address: Jukiceva 53, 71 000 Sarajevo Bosnia and Herzegovina, E-mail: meliha.mehic@ 123456bosnalijek.com , Telephone number: 00 387 33 254 596, Fax number: 00 387 33 814 250
                Article
                Publisher ID: MSM-28-454
                DOI: 10.5455/msm.2016.28.454-458
                PMC ID: 5239654
                PubMed ID: 28144199
                SO-VID: 3c850852-475a-406a-a838-fb289dc37535
                Copyright © Copyright: © 2016 Begler Begovic, Sead Ahmetagic, Lejla Calkic, Midhat Vehabovic, Sanela Bakic Kovacevic, Tarik Catic, Meliha Mehic
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 21 October 2016
                Date accepted : 10 December 2016
                Categories
                Subject: Original Paper

                Keywords: acute diarrhea in adults,nifuroxazide,probiotics
                Data availability:
                Keywords: acute diarrhea in adults, nifuroxazide, probiotics

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