SayPro Recommendations for the Use of Antibiotics for the Treatment of Cholera

Summary Recommendations

1. Oral or intravenous hydration is the mainstay of cholera treatment.
2. In conjunction with hydration, treatment with antibiotics is recommended for severely ill patients. It is particularly recommended for patients who are severely or moderately dehydrated and continue to pass a large volume of stool during rehydration treatment. Antibiotic treatment is also recommended for all patients who are hospitalized.
3. Antibiotic choices should be informed by local antibiotic susceptibility patterns. In most countries, Doxycycline is recommended as first-line treatment for adults, while azithromycin is recommended as first-line treatment for children and pregnant women. During an epidemic or outbreak, antibiotic susceptibility should be monitored through regular testing of sample isolates from various geographic areas.
4. None of the guidelines recommend antibiotics as prophylaxis for cholera prevention, and all emphasize that antibiotics should be used in conjunction with aggressive hydration.
5. Education of health care workers, assurance of adequate supplies, and monitoring of practices are all important for appropriate dispensation of antibiotics.