NCT00359970

Brief Summary

In a previous study azithromycin proved as efficacious as levofloxacin in the treatment of travelers' diarrhea in Mexico. Because the addition of loperamide to some antibiotics (e.g., trimethoprim-sulfamethoxazole and ofloxacin) has proven more efficacious than antibiotic alone in the treatment of travelers' diarrhea, we decided to study the addition of loperamide to azithromycin. US adults with acute diarrhea in Guadalajara Mexico were randomized to receive azithromycin in two different doses or loperamide plus azithromycin. The duration of diarrhea was shorter (11 hours) in the combination-treated group compared to the antibiotic-treated groups (34 hours). The percentage of subjects continuing to pass 6 or more unformed stools in the first 24 hours was less (1.7%) in the combination-treated group than in the antibiotic-treated groups (20%). We feel loperamide should routinely be added to an antibiotic to optimize treatment of travelers' diarrhea.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
176

participants targeted

Target at P50-P75 for phase_4

Timeline
Completed

Started Jun 2002

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2002

Completed
1.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 1, 2003

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 1, 2003

Completed
3 years until next milestone

First Submitted

Initial submission to the registry

August 1, 2006

Completed
2 days until next milestone

First Posted

Study publicly available on registry

August 3, 2006

Completed
Last Updated

June 19, 2015

Status Verified

June 1, 2015

Enrollment Period

1.2 years

First QC Date

August 1, 2006

Last Update Submit

June 17, 2015

Conditions

Keywords

DiarrheaTravelTravelers' diarrheaAzithromycinLoperamideTreatmentAntibiotic

Outcome Measures

Primary Outcomes (1)

  • Hours from beginning treatment to passage of last unformed stool

    subjects recorded the time and form of all stools passed during a 4 day observation period

Secondary Outcomes (5)

  • Number of unformed stools passed per 24 hour period

    24 hours after treatment

  • Number of subjects with symptoms of enteric disease per 24 hour period

    24 hours after treatment

  • Number of treatment failures

    72 hours after treatment

  • Percent of subjects in whom enteropathogen isolated from an enrollment stool sample was eradicated from a day 5 stool

    5 days after treatment

  • Percent of subjects continuing to pass 3 or more (enrollment criteria) unformed stools in a 24 hour period

    24 hours after treatment

Study Arms (3)

Azithromycin 500 mg plus Placebo

ACTIVE COMPARATOR

a single 500 mg dose of Azitrhomycin at the start of treatment; a single loading dose of placebo at the start of treatment and then a dose of placebo after each loose stool

Drug: Azithromycin 500 mgOther: Placebo

Azithromycin 1000 mg plus Placebo

ACTIVE COMPARATOR

a single 1000 mg dose of Azitrhomycin at the start of treatment; a single loading dose of placebo at the start of treatment and then a dose of placebo after each loose stool

Drug: Azithromycin 1000 mgOther: Placebo

Azithromycin 500 mg plus Loperamide

EXPERIMENTAL

a single 500 mg dose of Azitrhomycin at the start of treatment; a single 4 mg loading dose of Loperamide at the start of treatment and then 2 mg Loperamide after each loose stool

Drug: Azithromycin 500 mgDrug: Loperamide

Interventions

A single 500 mg dose at the start of treatment

Also known as: Zithromax, Zmax
Azithromycin 500 mg plus LoperamideAzithromycin 500 mg plus Placebo

A single 1000 mg dose at the start of treatment

Also known as: Zithromax, Zmax
Azithromycin 1000 mg plus Placebo

A single 4 mg loading dose at the start of treatment and then 2 mg after each loose stool

Also known as: IModium, Loperamide HCl
Azithromycin 500 mg plus Loperamide
PlaceboOTHER

A single loading dose at the start of treatment and then a dose after each loose stool

Azithromycin 1000 mg plus PlaceboAzithromycin 500 mg plus Placebo

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Eligible subjects included men or women, recently arrived in Mexico, at least 18 years of age, who developed acute diarrhea, which was defined as passage of 3 or more unformed stools in the preceding 24 hours accompanied by one or more signs or symptoms of enteric infection (e.g., nausea, vomiting, abdominal cramps, tenesmus, passage of grossly bloody stools or fecal urgency) with a duration of illness of less than or equal to 72 hours.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Texas Enteric Disease Research Clinics

Guadalajara, Jalisco, Mexico

Location

Related Publications (2)

  • Adachi JA, Ericsson CD, Jiang ZD, DuPont MW, Martinez-Sandoval F, Knirsch C, DuPont HL. Azithromycin found to be comparable to levofloxacin for the treatment of US travelers with acute diarrhea acquired in Mexico. Clin Infect Dis. 2003 Nov 1;37(9):1165-71. doi: 10.1086/378746. Epub 2003 Sep 30.

    PMID: 14557959BACKGROUND
  • Ericsson CD, DuPont HL, Okhuysen PC, Jiang ZD, DuPont MW. Loperamide plus azithromycin more effectively treats travelers' diarrhea in Mexico than azithromycin alone. J Travel Med. 2007 Sep-Oct;14(5):312-9. doi: 10.1111/j.1708-8305.2007.00144.x.

    PMID: 17883462BACKGROUND

MeSH Terms

Conditions

Diarrhea

Interventions

AzithromycinLoperamide

Condition Hierarchy (Ancestors)

Signs and Symptoms, DigestiveSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

ErythromycinMacrolidesPolyketidesLactonesOrganic ChemicalsPiperidinesHeterocyclic Compounds, 1-RingHeterocyclic Compounds

Study Officials

  • Charles D. Ericsson, MD

    University of Texas Medical School at Houston

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor and Dr. and Mrs. Carl V. Vartian Professor in Infectious Diseases

Study Record Dates

First Submitted

August 1, 2006

First Posted

August 3, 2006

Study Start

June 1, 2002

Primary Completion

August 1, 2003

Study Completion

August 1, 2003

Last Updated

June 19, 2015

Record last verified: 2015-06

Locations