What antibiotics treat cholera


choleraIndicationsInfectious diseases Cholera is an infectious disease that manifests itself in severe diarrhea which, if left untreated, can quickly lead to dangerous dehydration and death. The cause of the disease is the colonization of the small intestine with the rod bacteria Vibrio cholerae, which is transmitted mainly faecal-orally via contaminated water and food. Electrolyte replacement solutions, intravenous fluids, antibiotics, and zinc are used for treatment. Vaccines are available for drug prevention.

synonym: Vibrio cholerae

Symptoms

Cholera manifests itself in a strong, watery, milky-white diarrhea ("rice water"), which leads to a large loss of fluids and electrolytes and dehydration and drying out within hours. Other possible symptoms are nausea and vomiting. The massive loss of fluids can lead to shock, kidney failure, convulsions, coma and, if left untreated, death in up to half of the cases. However, the infection is often symptom-free and can only trigger mild diarrhea that cannot be distinguished from other causes.

causes

The cause of the disease is the colonization of the small intestine with the gram-negative, comma-shaped rod bacterium Vibrio cholerae of serotypes O1 and O139. The bacteria are mainly transmitted faecal-orally via contaminated water and food. A high dose is required for infection. The incubation period is a few days. The bacteria produce the cholera toxin, which inhibits the absorption of electrolytes and at the same time promotes their secretion, which leads to massive diarrhea because a lot of water gets into the intestines.

Cholera is practically eradicated in the western industrialized nations, but it is endemic in Asia and Africa in particular. The outbreaks after humanitarian catastrophes, such as the severe earthquake in Haiti in 2010, are feared. Poverty, a lack of water treatment, no sanitary facilities or treatment of water, as well as inadequate health care encourage the emergence of epidemics. It is estimated that over 100,000 people die of cholera every year around the world.

Medication

It is important to get the patient to treatment as soon as possible, as the disease can become severe within hours. With the right therapy, mortality can be greatly reduced.

Oral Rehydration Solution (ORS) is used to replace lost fluid and electrolytes and to correct metabolic disorders. If the course is severe, intravenous administration is necessary.

Antibiotics such as macrolides (azithromycin), tetracyclines (doxycycline), quinolones (ciprofloxacin) and cotrimoxazole shorten the duration of the disease, reduce the severity and reduce the risk of infection. They are also given for chemoprophylaxis. One problem is the development of resistant pathogens.

Zinc supplements also shorten the duration and reduce the symptoms of the disease, which has been proven especially in children.

The drugs used are also combined with other drugs such as vitamin A and antihelminthics in order to treat deficiencies and diseases at the same time.

Vaccines are available for prevention. The DukoralĀ® suspension, which contains inactivated bacteria and is taken orally, is approved in Switzerland. It protects adults up to 2 years.

prevention

Important points:

  • Drink and use clean water
  • Wash hands frequently with soap and water
  • Use toilets, do not defecate in the water
  • Cook the food well
  • Good hygiene in the living rooms and toilets
  • Rapid treatment of the sick
literature
  • Bhattacharya S.K. An evaluation of current cholera treatment. Expert Opin Pharmacother, 2003, 4 (2), 141-6 Pubmed
  • CDC http://www.cdc.gov/cholera/index.html
  • Farmer P. et al. Meeting cholera's challenge to Haiti and the world: a joint statement on cholera prevention and care. PLoS Negl Trop Dis, 2011, 5 (5), e1145 Pubmed
  • Ghosh A., Ramamurthy T. Antimicrobials & cholera: are we stranded? Indian J Med Res, 2011, 133 (2), 225-31 Pubmed
  • Sack D.A., Sack R.B., Nair G.B., Siddique A.K. Cholera. Lancet, 2004, 363 (9404), 223-33 Pubmed
  • Sanchez J., Holmgren J. Cholera toxin - a foe & a friend. Indian J Med Res, 2011, 133 (2), 153-63 Pubmed
  • Shin S., Desai S.N., Sah B.K., Clemens J.D. Oral vaccines against cholera. Clin Infect Dis, 2011, 52 (11), 1343-9 Pubmed
  • Thiagarajah J.R., Verkman A.S. New drug targets for cholera therapy. Trends Pharmacol Sci, 2005, 26 (4), 172-5 Pubmed
  • Topps M.H. Oral cholera vaccine - for whom, when, and why? Travel Med Infect Dis, 2006, 4 (1), 38-42 Pubmed
  • Zuckerman J.N., Rombo L., Fisch A. The true burden and risk of cholera: implications for prevention and control. Lancet Infect Dis, 2007, 7 (8), 521-30 Pubmed
author

Conflicts of Interest: None / Independent. The author has no relationships with the manufacturers and is not involved in the sale of the products mentioned.


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This article was last changed on 7/12/2020.
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