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A single dose of azithromycin was more effective than ciprofloxacin for severe cholera in men in Bangladesh

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 Q Are single dose azithromycin and single dose ciprofloxacin equivalent for treatment of severe cholera in adults?

Clinical impact ratings Tropical & travel medicine ★★★★★★★ Infectious disease ★★★★★★☆ Endocrine ★★★★★★☆


Embedded ImageDesign:

randomised controlled trial.

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded {patients, healthcare providers, data collectors, outcome assessors, data analysts, and monitoring committee}.*

Embedded ImageFollow up period:

48 hours (for primary outcome).

Embedded ImageSetting:

a diarrhoea treatment centre in Dhaka, Bangladesh.

Embedded ImagePatients:

198 men 18–60 years of age (median age 25 y) who had watery diarrhoea for ⩽24 hours, severe dehydration, a high purging rate (stool volume ⩾20 ml/kg body weight over a 4 hour period after initial rehydration), and isolation of Vibrio cholerae O1 or O139 from a stool or rectal swab sample. Exclusion criteria were concomitant illness or receipt of an antimicrobial agent effective for treatment of cholera.

Embedded ImageIntervention:

azithromycin, two 500 mg tablets, plus a placebo formulation of ciprofloxacin …

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  • * See glossary.

  • Information provided by author.

  • For correspondence: Dr D Saha, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh. dsaha{at}

  • Sources of funding: Pfizer, National Institute of Allergy and Infectious Diseases; Wellcome Trust. Pfizer provided azithromycin tablets, and Square Pharmaceuticals provided ciprofloxacin tablets.

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