A randomized clinical trial to compare the efficacy of erythromycin, ampicillin and tetracycline for the treatment of cholera in children

S. K. Roy, A. Islam, R. Ali, K. E. Islam, R. A. Khan, S. H. Ara, N. M. Saifuddin, G. J. Fuchs

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


To compare the clinical outcome of treatment of cholera in children with ampicillin, erythromycin or tetracycline, a double-'blind' randomized four-cell trial was carried out in Bangladesh. Ampicillin was chosen as additional therapy for acute respiratory tract infection, present in many subjects with diarrhoea. One hundred and eighty-four children aged 1-5 years who were not wasted, with diarrhoea of duration < 48 h, signs of some or severe dehydration, dark-field stool microscopy demonstrating Vibrio cholerae, and a baseline purging rate > 4 mL/kg/h over 6 h were enrolled in the study. Ampicillin, tetracycline, erythromycin or placebo were given orally every 6 h for 3 d. After 3 d of antibiotic treatment, diarrhoeal stool volume was significantly reduced in all antibiotic groups, with mean volumes per kg body weight as follows: tetracycline, 318 mL (SEM = 50), ampicillin, 335 mL (SEM = 30); erythromycin, 323 mL (SEM = 25); placebo, 498 mL (SEM = 37). Compared to tetracycline, the clinical recovery rates by 96 h were 75% with placebo, 91.3% with ampicillin, and 95.7% with eythromycin. Compared to tetracycline, the total mean times to recovery were increased by 66% with placebo (P < 0.001), 25% with ampicillin (P < 0.017), and 9% with erythromycin (P = 0.37). These results indicated comparable clinical efficacy of tetracycline, ampicillin and erythromycin. We therefore recommend that, unless V. cholerae is resistant, ampicillin should be used as a cost-effective alternative to erythromycin for paediatric cholera, especially in children with concomitant acute respiratory infection.

Original languageEnglish
Pages (from-to)460-462
Number of pages3
JournalTransactions of the Royal Society of Tropical Medicine and Hygiene
Issue number4
StatePublished - 1998

Bibliographical note

Funding Information:
Acknowledgements This research was supported by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B). The ICDDR, B is supported by countries and agencies which share its concern for the health problems of developing countries. Current donors include: the aid agencies of the Governments of Australia, Bangladesh, Belgium, Canada, Japan, The Netherlands, Norway, Saudi Arabia, Sri Lanka, Sweden, Switzerland, the United Kingdom and the United States; international organizations including the Arab Gulf Fund, the European Union, the United Nations Children’s Fund (UNICEF), the United Nations Development Programme and the World Health Organization; private foundations including the Aga Khan Foundation, the Child Health Foundation, the Ford Foundation, the Population Council, the Rockefeller Foundation, the Thrasher Foundation, and the George Mason Foundation; and private organizations including East-West Center, Helen Keller International, the International Atomic Energy Agency, the International Centre for Research on Women, the International Development Research Centre, the International Life Sciences Institute, the Karolinska Institute, the London School of Hygiene and Tropical Medicine, Lederle Praxis, the National Institutes of Health, the New England Medical Center, Proctor & Gamble, the Rand Corporation, the Social Development Center of the Philippines, the Swiss Red Cross, the Johns Hopkins University, the University of Alabama at Birmingham, the University of Iowa, the University of Goteborg, UCB Osmotics Ltd, Wander AG, and others.


  • Ampicillin
  • Bangladesh
  • Children
  • Cholera
  • Erythromycin
  • Tetracycline
  • Vibrio cholerae

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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