Table 3.
Antibiotics for cholera.
| Class | Antibiotic | Pediatric Dose* | Adult Dose | Comment(s) |
|---|---|---|---|---|
| Tetracyclines | Tetracycline | 12.5 mg/kg/dose QID × 3 days |
500 mg QID × 3 days |
Antibiotic resistance to all tetracyclines is common (139) Empiric use is most appropriate in outbreaks caused by documented susceptible isolates. Tetracyclines are not recommended for pregnant women or children less than 8 years because of risk of irreversible discoloration of permanent teeth. |
| Doxycycline | 4–6 mg/kg × single dose |
300 mg × single dose |
||
| Fluoroquinolones | Ciprofloxacin | 15 mg/kg/dose BID × 3 days |
500 mg BID × 3 days |
In highly susceptible strains, single dose ciprofloxacin compares favorably against erythromycin (140) and doxycycline (141) in randomized trials. However, reduced susceptibility to fluoroquinolones has become common in endemic areas, and is associated with treatment failure (142;143). |
| Macrolides | Erythromycin | 12.5 mg/kg/dose QID × 3 days |
250 mg QID × 3 days |
Single dose azithromycin is the preferred therapy in children and has been shown to be more effective than ciprofloxacin in randomized trials in regions where reduced susceptibility to flouroquinolones are common (142;144). There are rare reports of macrolide resistance. |
| Azithromycin | 20 mg/kg × single dose |
1 gram × single dose |
*
Pediatric doses, based on weight, should not exceed maximum adult dose
QID: four times a day
BID, twice a day