To evaluate single doses of 400 mg of
furazolidone and 1 g of
tetracycline given orally to patients with
diarrhea due to Vibrio cholerae, we studied 87 adults in a randomized, double-blind, placebo-controlled trial. All patients received intravenous fluids for
rehydration and no other drugs. The total volumes of stool (mean +/- standard deviation) during a 6-day period
after treatment were significantly smaller in the
tetracycline group (10.5 +/- 8.6 liters) than in the
furazolidone group (20.9 +/- 15.9 liters) and the placebo group (19.1 +/- 10.5 liters) (P less than 0.01). The duration of
diarrhea and volumes of intravenous fluids were also significantly reduced in the
tetracycline group (P less than 0.05). However, there were no differences between the
furazolidone and the placebo groups with regard to stool volume, intravenous fluid, and duration of
diarrhea. Within 48 h of treatment,
tetracycline significantly reduced the number of patients with positive stool cultures for V. cholerae (37%) compared with
furazolidone treatment (96%) and the placebo (97%) (P less than 0.001). Although the
tetracycline group had a significantly higher incidence (61%) of bacteriologic relapse (negative stool cultures on days 2 and 3, followed by positive cultures afterward) compared with that in the
furazolidone group (40%) and the placebo group (33%), this was not associated with clinical relapse. There were no differences between the
furazolidone and placebo groups with regard to any of the bacteriologic responses examined. These data indicate that a single dose of 1 g of
tetracycline is effective in the treatment of
cholera, but it is asymptomatic bacteriologic relapse. A single dose of 400 mg of
furazolidone is not therapeutically effective in
cholera.