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Treatment of cholera includes (a) replacement of fluid and electrolytes and (b) antibiotic therapy.
Treatment of cholera is primarily based on prompt and adequate replacement of fluid and electrolytes, before the resultant mas-sive loss of fluid leads to hypovolemic shock. Replacement of fluid by oral administration of fluid containing glucose and elec-trolytes is the most successful and highly effective method for treatment of cholera. The oral rehydration therapy (ORT) solu-tion consisting of glucose, sodium chloride, potassium chloride, and sodium citrate is widely used. The glucose facilitates absorp-tion of sodium in the small intestine, and salts present in the ORT restore the electrolyte balance and thereby reverse acidosis.
The ORT is highly cost-effective and is simple to use; hence it is widely used with tremendous success in developing coun-tries endemic for cholera. Cereal-based preparation, such as thoroughly cooked and salted rice soup, is also equally effective for treatment of dehydration in cases of cholera. Immediate intravenous fluid therapy is usually recommended for more serious cases of dehydration.
Antibiotic therapy is of secondary importance and is a supple-ment to fluid therapy. Treatment with antibiotics diminishes the duration and volume of fluid loss. It also hastens clear-ance of the Vibrio organisms from the intestine. V. cholerae are uniformly sensitive to tetracycline, ciprofloxacin, and eryth-romycin. Tetracycline or doxycycline is the drug of choice for adults and trimethoprim–sulfamethoxazole for children. Pyrazolidone is the usually recommended treatment for preg-nant females suffering from cholera. Of late, strains resistant to ciprofloxacin have been documented from Kolkata, India.
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