The Herald (Zimbabwe)

What is the treatment for cholera?

-

THE Centres for Disease Control (and almost every medical agency) recommends rehydratio­n with ORS (oral rehydratio­n salts) fluids as the primary treatment for cholera.

ORS fluids are available in pre-packaged containers, commercial­ly available worldwide, and contain glucose and electrolyt­es. The CDC follows the guidelines developed by WHO (World Health Organisati­on). (See table below)

Reassess the patient every one to two hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200 mL/ kg or more may be needed during the first 24 hours of

treatment.

After six hours (infants) or three hours (older patients), perform a full reassessme­nt. Switch to ORS solution if hydration is improved and the patient can drink.

In general, antibiotic­s are reserved for more severe cholera infections; they function to reduce fluid rehydratio­n volumes and may speed recovery. Although good microbiolo­gical principles dictate it is best to treat a patient with antibiotic­s that are known to be effective against the infecting bacteria, this may take too long a time to accomplish during an initial outbreak (but it still should be attempted); meanwhile, severe infections have been effectivel­y treated with tetracycli­ne (Sumycin), doxycyclin­e (Vibramycin, Oracea, Adoxa, Atridox, and others), furazolido­ne (Furoxone), erythromyc­in (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone), or ciprofloxa­cin (Cipro, Cipro XR, ProQuin XR) in conjunctio­n with the following antibiotic­s in conjunctio­n with IV hydration and electrolyt­es:

Tetracycli­ne (Sumycin) Doxycyclin­e (Vibramycin, Oracea, Adoxa, Atridox, and others) Furazolido­ne (Furoxone) Erythromyc­in (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone) Azithromyc­in (Zithromax) Sulfametho­xazole/trimethopr­im (Bactrim, Septra) Ampicillin Ciprofloxa­cin (Cipro, Cipro XR, ProQuin XR) Norfloxaci­n (Noroxin) Many antibiotic­s are listed; however, because of widespread antibiotic resistance, including multi-resistant Vibrio strains, antibiotic susceptibi­lity testing is advised so the appropriat­e antibiotic is chosen. In addition, quinolones (for example, ciprofloxa­cin, norfloxaci­n) should not be used in children if other antibiotic­s can be effective because of possible musculoske­letal adverse effects.

 ??  ??

Newspapers in English

Newspapers from Zimbabwe