One hundred and eight male adults (mean age 33 +/- 1.7 years) presenting with watery diarrhoea of less than 48 hours duration at home prior to hospitalization and with clinically evident (grade II, severe)
dehydration were admitted into a randomized double-blind clinical trial; 54 were treated with standard
oral rehydration solution (
ORS)--WHO formulation containing
citrate--and 54 with an improved
ORS formulation which contained, in addition to the standard formula,
maltodextrin 20 g (instead of
glucose),
glycine 4 g and
glycyl-glycine 4 g. Patients with clinical
cholera were given
tetracycline 500 mg q.i.d. Vibrio cholerae was detected in 85 patients. The clinical characteristics of patients in the two groups were comparable. The improved
ORS did not reduce the volume of diarrhoeic stools in
cholera; indeed, patients with
cholera who were treated with improved
ORS had larger diarrhoea stool volumes. However, those
cholera patients given improved
ORS showed significantly greater
weight gains during the first six-hour period, at the end of the second day, and at discharge. On the other hand, non-
cholera patients treated with improved
ORS had significantly smaller diarrhoeic stool volumes during the six to 24-hour significantly smaller diarrhoeic stool volumes during the six to 24-hour period (i.e. during the commencement of maintenance
rehydration therapy).