Antidiarrheal effects of L-histidine-supplemented rice-based oral rehydration solution in the treatment of male adults with severe cholera in Bangladesh

A double-blind, randomized trial

Golam H. Rabbani, David A. Sack, Shamsir Ahmed, Johnny Peterson, Shyamal K. Saha, Farzana Marni, Peter Thomas

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background. Because of the antisecretory potential of L-histidine in the intestinal tract, its antidiarrheal effects were determined in cholera. Methods. In a double-blind trial of 126 adult male patients with cholera, L-histidine (2.5 g/L) was mixed with a rice-based oral rehydration solution (ORS) and administered to 62 patients; 64 patients received the same ORS without L-histidine. All patients received ciprofloxacin at a dosage of 500 mg every 12 h for 72 h. Fluid output (of stool, urine, and vomit) and intake (of ORS, water, and intravenous fluid) were determined every 8 h for 72 h. Results. Administration of ORS with L-histidine significantly (P<.05) reduced the frequency of stool output during 32-64 h after initiation of ORS treatment, compared with that in patients given ORS without L-histidine ([all data are means ± SD] 32-48 h, 11.5 ± 6.9 mL/kg vs. 18.8 ± 16.0 mL/kg; 40-48 h, 6.7 ± 4.4 mL/kg vs. 11.5 ± 9.7 mL/kg; and 56-64 h, 6.3 ± 5.8 mL/kg vs. 7.8 ± 4.1 mL/kg). An overall reduction of 22% in the volume of stool was observed in patients given ORS without L-histidine. The amount of required unscheduled intravenous fluid was lower in patients given ORS with L-histidine, compared with that in patients given ORS without L-histidine (0-24 h, 82.5 ± 44.4 mL/kg vs. 158.6 ± 72.2 mL/kg [P<.01]; and 24-48 h, 41.6 ± 40.4 mL/kg vs. 52.5 ± 22.1 mL/kg [P>.05]). Administration of ORS with L-histidine also significantly reduced (P<.05) the intake of ORS and the duration of illness. No adverse effects were observed in these patients. Conclusions. L-histidine reduces the weight of stool and the frequency of stool output in cholera and could be a useful and safe adjunct treatment that will increase the success rate of ORS and antibiotic therapy in cholera.

Original languageEnglish (US)
Pages (from-to)1507-1514
Number of pages8
JournalJournal of Infectious Diseases
Volume191
Issue number9
DOIs
StatePublished - May 1 2005

Fingerprint

Rehydration Solutions
Antidiarrheals
Bangladesh
Cholera
Fluid Therapy
Histidine
Therapeutics
Ciprofloxacin
Oryza
Urine
Anti-Bacterial Agents
Weights and Measures
Water

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

Antidiarrheal effects of L-histidine-supplemented rice-based oral rehydration solution in the treatment of male adults with severe cholera in Bangladesh : A double-blind, randomized trial. / Rabbani, Golam H.; Sack, David A.; Ahmed, Shamsir; Peterson, Johnny; Saha, Shyamal K.; Marni, Farzana; Thomas, Peter.

In: Journal of Infectious Diseases, Vol. 191, No. 9, 01.05.2005, p. 1507-1514.

Research output: Contribution to journalArticle

@article{efc39cf4a1d7403c8193940e94dcd19d,
title = "Antidiarrheal effects of L-histidine-supplemented rice-based oral rehydration solution in the treatment of male adults with severe cholera in Bangladesh: A double-blind, randomized trial",
abstract = "Background. Because of the antisecretory potential of L-histidine in the intestinal tract, its antidiarrheal effects were determined in cholera. Methods. In a double-blind trial of 126 adult male patients with cholera, L-histidine (2.5 g/L) was mixed with a rice-based oral rehydration solution (ORS) and administered to 62 patients; 64 patients received the same ORS without L-histidine. All patients received ciprofloxacin at a dosage of 500 mg every 12 h for 72 h. Fluid output (of stool, urine, and vomit) and intake (of ORS, water, and intravenous fluid) were determined every 8 h for 72 h. Results. Administration of ORS with L-histidine significantly (P<.05) reduced the frequency of stool output during 32-64 h after initiation of ORS treatment, compared with that in patients given ORS without L-histidine ([all data are means ± SD] 32-48 h, 11.5 ± 6.9 mL/kg vs. 18.8 ± 16.0 mL/kg; 40-48 h, 6.7 ± 4.4 mL/kg vs. 11.5 ± 9.7 mL/kg; and 56-64 h, 6.3 ± 5.8 mL/kg vs. 7.8 ± 4.1 mL/kg). An overall reduction of 22{\%} in the volume of stool was observed in patients given ORS without L-histidine. The amount of required unscheduled intravenous fluid was lower in patients given ORS with L-histidine, compared with that in patients given ORS without L-histidine (0-24 h, 82.5 ± 44.4 mL/kg vs. 158.6 ± 72.2 mL/kg [P<.01]; and 24-48 h, 41.6 ± 40.4 mL/kg vs. 52.5 ± 22.1 mL/kg [P>.05]). Administration of ORS with L-histidine also significantly reduced (P<.05) the intake of ORS and the duration of illness. No adverse effects were observed in these patients. Conclusions. L-histidine reduces the weight of stool and the frequency of stool output in cholera and could be a useful and safe adjunct treatment that will increase the success rate of ORS and antibiotic therapy in cholera.",
author = "Rabbani, {Golam H.} and Sack, {David A.} and Shamsir Ahmed and Johnny Peterson and Saha, {Shyamal K.} and Farzana Marni and Peter Thomas",
year = "2005",
month = "5",
day = "1",
doi = "10.1086/428449",
language = "English (US)",
volume = "191",
pages = "1507--1514",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "9",

}

TY - JOUR

T1 - Antidiarrheal effects of L-histidine-supplemented rice-based oral rehydration solution in the treatment of male adults with severe cholera in Bangladesh

T2 - A double-blind, randomized trial

AU - Rabbani, Golam H.

AU - Sack, David A.

AU - Ahmed, Shamsir

AU - Peterson, Johnny

AU - Saha, Shyamal K.

AU - Marni, Farzana

AU - Thomas, Peter

PY - 2005/5/1

Y1 - 2005/5/1

N2 - Background. Because of the antisecretory potential of L-histidine in the intestinal tract, its antidiarrheal effects were determined in cholera. Methods. In a double-blind trial of 126 adult male patients with cholera, L-histidine (2.5 g/L) was mixed with a rice-based oral rehydration solution (ORS) and administered to 62 patients; 64 patients received the same ORS without L-histidine. All patients received ciprofloxacin at a dosage of 500 mg every 12 h for 72 h. Fluid output (of stool, urine, and vomit) and intake (of ORS, water, and intravenous fluid) were determined every 8 h for 72 h. Results. Administration of ORS with L-histidine significantly (P<.05) reduced the frequency of stool output during 32-64 h after initiation of ORS treatment, compared with that in patients given ORS without L-histidine ([all data are means ± SD] 32-48 h, 11.5 ± 6.9 mL/kg vs. 18.8 ± 16.0 mL/kg; 40-48 h, 6.7 ± 4.4 mL/kg vs. 11.5 ± 9.7 mL/kg; and 56-64 h, 6.3 ± 5.8 mL/kg vs. 7.8 ± 4.1 mL/kg). An overall reduction of 22% in the volume of stool was observed in patients given ORS without L-histidine. The amount of required unscheduled intravenous fluid was lower in patients given ORS with L-histidine, compared with that in patients given ORS without L-histidine (0-24 h, 82.5 ± 44.4 mL/kg vs. 158.6 ± 72.2 mL/kg [P<.01]; and 24-48 h, 41.6 ± 40.4 mL/kg vs. 52.5 ± 22.1 mL/kg [P>.05]). Administration of ORS with L-histidine also significantly reduced (P<.05) the intake of ORS and the duration of illness. No adverse effects were observed in these patients. Conclusions. L-histidine reduces the weight of stool and the frequency of stool output in cholera and could be a useful and safe adjunct treatment that will increase the success rate of ORS and antibiotic therapy in cholera.

AB - Background. Because of the antisecretory potential of L-histidine in the intestinal tract, its antidiarrheal effects were determined in cholera. Methods. In a double-blind trial of 126 adult male patients with cholera, L-histidine (2.5 g/L) was mixed with a rice-based oral rehydration solution (ORS) and administered to 62 patients; 64 patients received the same ORS without L-histidine. All patients received ciprofloxacin at a dosage of 500 mg every 12 h for 72 h. Fluid output (of stool, urine, and vomit) and intake (of ORS, water, and intravenous fluid) were determined every 8 h for 72 h. Results. Administration of ORS with L-histidine significantly (P<.05) reduced the frequency of stool output during 32-64 h after initiation of ORS treatment, compared with that in patients given ORS without L-histidine ([all data are means ± SD] 32-48 h, 11.5 ± 6.9 mL/kg vs. 18.8 ± 16.0 mL/kg; 40-48 h, 6.7 ± 4.4 mL/kg vs. 11.5 ± 9.7 mL/kg; and 56-64 h, 6.3 ± 5.8 mL/kg vs. 7.8 ± 4.1 mL/kg). An overall reduction of 22% in the volume of stool was observed in patients given ORS without L-histidine. The amount of required unscheduled intravenous fluid was lower in patients given ORS with L-histidine, compared with that in patients given ORS without L-histidine (0-24 h, 82.5 ± 44.4 mL/kg vs. 158.6 ± 72.2 mL/kg [P<.01]; and 24-48 h, 41.6 ± 40.4 mL/kg vs. 52.5 ± 22.1 mL/kg [P>.05]). Administration of ORS with L-histidine also significantly reduced (P<.05) the intake of ORS and the duration of illness. No adverse effects were observed in these patients. Conclusions. L-histidine reduces the weight of stool and the frequency of stool output in cholera and could be a useful and safe adjunct treatment that will increase the success rate of ORS and antibiotic therapy in cholera.

UR - http://www.scopus.com/inward/record.url?scp=17644405429&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=17644405429&partnerID=8YFLogxK

U2 - 10.1086/428449

DO - 10.1086/428449

M3 - Article

VL - 191

SP - 1507

EP - 1514

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 9

ER -