Clinical and bacteriologic response to single-dose or multiple-dose ciprofloxacin therapy in patients infected with nalidixic acid-resistant strains of <i>V</i>. <i>cholerae</i> O1.

<p>Values are median (25^th–75^th centile) unless noted.</p><p>* Based on weight discharge</p><p>Clinical and bacteriologic response to single-dose or multiple-dose ciprofloxacin therapy in patients infected with nalidixic acid-resistant strains of <i>V</i>. <i>cholerae</i> O1.</p

Nalidixic acid and ciprofloxacin MIC⁵⁰and MIC⁹⁰ of 275 isolates of <i>V cholerae</i> O1 by year and source of strains obtained.

<p>Values are (μg/ml)</p><p>CT–Clinical trial; CLS–Clinical Laboratory Services, icddr,b</p><p>Nalidixic acid and ciprofloxacin MIC⁵⁰and MIC⁹⁰ of 275 isolates of <i>V cholerae</i> O1 by year and source of strains obtained.</p

Admission characteristics and response to ciprofloxacin therapy in 161 patients infected with nalidixic acid-susceptible and nalidixic acid-resistant strains of <i>V</i>. <i>cholerae</i> O1.

<p>Values are median (25^th, 75^th centiles) unless noted</p><p>* Based on disc-diffusion method</p><p>^‡ Based on discharge weight</p><p>Admission characteristics and response to ciprofloxacin therapy in 161 patients infected with nalidixic acid-susceptible and nalidixic acid-resistant strains of <i>V</i>. <i>cholerae</i> O1.</p

Randomized controlled trials from which 161 adult patients infected with <i>V</i>. <i>cholerae</i> O1;treated with ciprofloxacin and completed 5day study were included in this analysis.

<p>There were 580 patients in total in these four studies, of whom 161 (28%) were infected with <i>V</i>.<i>cholerae</i> O1; treated with ciprofloxacin and completed 5 day study</p><p>Randomized controlled trials from which 161 adult patients infected with <i>V</i>. <i>cholerae</i> O1;treated with ciprofloxacin and completed 5day study were included in this analysis.</p

Clinical and bacteriologic response to single-dose or multiple-dose ciprofloxacin therapy in patients infected with nalidixic acid-resistant strains of <i>V</i>. <i>cholerae</i> O1.

<p>Values are median (25^th–75^th centile) unless noted.</p><p>* Based on weight discharge</p><p>Clinical and bacteriologic response to single-dose or multiple-dose ciprofloxacin therapy in patients infected with nalidixic acid-resistant strains of <i>V</i>. <i>cholerae</i> O1.</p

Clinical and bacteriologic response to single-dose or multiple-dose ciprofloxacin therapy in patients infected with nalidixic acid-susceptible strains of <i>V</i>. <i>cholerae</i> O1.

<p>Values are median (25^th–75^th centiles) unless noted</p><p>* Based on discharge weight</p><p>Clinical and bacteriologic response to single-dose or multiple-dose ciprofloxacin therapy in patients infected with nalidixic acid-susceptible strains of <i>V</i>. <i>cholerae</i> O1.</p

G6PD Deficiency and Antimalarial Efficacy for Uncomplicated Malaria in Bangladesh: A Prospective Observational Study

<div><p>Background</p><p>The Bangladeshi national treatment guidelines for uncomplicated malaria follow WHO recommendations but without G6PD testing prior to primaquine administration. A prospective observational study was conducted to assess the efficacy of the current antimalarial policy.</p><p>Methods</p><p>Patients with uncomplicated malaria, confirmed by microscopy, attending a health care facility in the Chittagong Hill Tracts, Bangladesh, were treated with artemether-lumefantrine (days 0–2) plus single dose primaquine (0.75mg/kg on day2) for <i>P</i>. <i>falciparum</i> infections, or with chloroquine (days 0–2) plus 14 days primaquine (3.5mg/kg total over 14 days) for <i>P</i>. <i>vivax</i> infections. Hb was measured on days 0, 2 and 9 in all patients and also on days 16 and 30 in patients with <i>P</i>. <i>vivax</i> infection. Participants were followed for 30 days. The study was registered with the clinical trials website (NCT02389374).</p><p>Results</p><p>Between September 2014 and February 2015 a total of 181 patients were enrolled (64% <i>P</i>. <i>falciparum</i>, 30% <i>P</i>. <i>vivax</i> and 6% mixed infections). Median parasite clearance times were 22.0 (Interquartile Range, IQR: 15.2–27.3) hours for <i>P</i>. <i>falciparum</i>, 20.0 (IQR: 9.5–22.7) hours for <i>P</i>. <i>vivax</i> and 16.6 (IQR: 10.0–46.0) hours for mixed infections. All participants were afebrile within 48 hours, two patients with <i>P</i>. <i>falciparum</i> infection remained parasitemic at 48 hours. No patient had recurrent parasitaemia within 30 days. Adjusted male median G6PD activity was 7.82U/gHb. One male participant (1/174) had severe G6PD deficiency (<10% activity), five participants (5/174) had mild G6PD deficiency (10–60% activity). The Hb nadir occurred on day 2 prior to primaquine treatment in <i>P</i>. <i>falciparum</i> and <i>P</i>. <i>vivax</i> infected patients; mean fractional fall in Hb was -8.8% (95%CI -6.7% to -11.0%) and -7.4% (95%CI: -4.5 to -10.4%) respectively.</p><p>Conclusion</p><p>The current antimalarial policy remains effective. The prevalence of G6PD deficiency was low. Main contribution to haemolysis in G6PD normal individuals was attributable to acute malaria rather than primaquine administration.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="https://www.clinicaltrials.gov/ct2/show/NCT02389374?term=NCT02389374&rank=1" target="_blank">NCT02389374</a></p></div

Baseline characteristics.

<p>Baseline characteristics.</p

Average total dose of drug (mg/kg) administered.

<p>Pf: <i>Plasmodium falciparum</i>, Pv: <i>Plasmodium vivax</i>, Pf/Pv: mixed infections.</p

Mean fractional reduction in Hb concentration between baseline and the day of follow up.

<p>ND: Not done. Cell values represent the mean % fall (95% CI) and the number of patients (n) included in the analysis.</p