2BAMS (BRABU); MHA, Director (Hon), Aarogyam Punarjeevan, Ram Bhawan, Ara Garden Road, Jagdeopath, Baily Road, Patna
3BAMS (BRABU), Ex Director, Centre for Indigenous Medicine & Research, Senior Research Fellow, Regional Research Institute of Ayurveda, Itanagar, Arunachal Pradesh Bahrain
| Watery diarrhoea : lasts for several days
Acute diarrhoea with blood : also known as dysentery
Persistent diarrhoea : lasts for 14 days or more
- Potent effect against intestinal micro organisms
- Must have low absorption and low volume distribution to have maximum effect to counter intestinal infection
- Must get excreted through kidney as migration of intestinal commensal through systemic circulation may cause post diarrhoeal urinary tract infection which in turn results in suppression of erythropoietin and erythropoiesis leading to chronic anaemia
- Amoebicidal must be potent and active against both local and extra intestinal protozoal infection
- It should not pose any toxic or untoward effect
Evaluate the rationality of ofloxacin use in diarrhoea management
Study was conducted during January 2014 to December 2016 and cases were followed for 6 months post therapy for drug related or disease related untoward effects.
Ethical committee of the National Institute of Health & Research duly permitted the study, based on case data.
Patients attending Centre For Research in Diarrhoeal Disease, National Institute of Health & Research, Warisaliganj (Nawada) Bihar and Aarogyam Punarjeevan, Ara Garden Road Jagdeo path, Baily Road, Patna 14 suffering with lose motion were selected for the evaluation and justification for use of Ofloxacin in management of diarrhoea. Patients of diarrhoea with septicaemia or any other complication were excluded from the study.
Data sheet of patient of diarrhoea attended for treatment at RA Hospital & Research Centre are analysed for the clinical presentation, duration of illness, therapeutics taken, their response and were duly investigated for basic bio parameters, stool examination, urine routine and culture to asses clinical effect, disease sequel and drug adversity.
|Degree of severity||Characteristic features|
|Mild||Lose motion with mucous without fowl smell Frequency of motion 5/day Mild dehydration|
|Moderate||lose motion with mucous with fowl smell Frequency up to 10 /day Moderate dehydration|
|Severe||Watery fowl smelling stool Frequency >12/day Severe dehydration|
|Moderate||irritable, weak pulse, reduced urine output Anterior fontanelle depressed, eye ball sunken, face dry and parched lips and buccal mucosa dry, skin turgor lost thirsty|
|Severe||moribund, apathetic, pulse weak, thread Marked reduced in the urine volume Fontanelle depressed, eye ball markedly sunken Lips parched, face markedly dried and pinched Buccal mucosa dry, loss of skin turgor and thirsty|
Ornidazol and Ofloxacin: Group A
Tinidazol and Norfloxacin: Group B
Tinidazole and Co trimoxazole: Group C
Children: 2.5-5 ml every 12 hours
Adult: 1 tab every 12 hours
Children: 10-15mg sachet every 8 hours
Adult: 100mg Cap every 8 hours
|Grade I (Excellent)||Decline in frequency and change in consistency of Stool, formed stool in 12 hrs. Recovery with minimal Water and electrolyte supplementation, reduced Duration of illness and ultimately cost of therapy Without any drug or diseases related untoward effect No reversal, No post therapy sequel|
|Grade II (Good)||Decline in frequency and change in consistency of stool in 48 hours, recovery on fluid and electrolyte intravenous Supplementation, persistence of 2-4 lose mition daily with post therapy sequel|
|Grade III (Poor)||No response, worsening of diarrhoea|
Selected patients were of age group 5-50 years and 572 were male and 468 female (T-1, figure 1). Out of all majority patients 436 (42%) were presenting with 5 motions per day while 210(20.2%) were with >12 motions per day (Figure 2) 508(48%) patients were presenting with watery fowl smelling stool, 344 (33%) with mucous and fowl smell while 188(18.1%) were with non-fowl smelling stool presenting since long duration (figure -3). Out of all 488 patients presented within 24 hours of illness while 198 after 5 days (figure -4). Stool examination reveals 276 (26.5%) viral, 504 (48.5%) bacterial, 140(13.5%) protozoal and 120 (11.5%) parasitic. (T-2). 59.6% patients are on Ofloxacin-Ornidazol, 27% Norfloxacin-Tinidazole and 13.4% on Co trimoxazole-Tinidazole combination (T-3)
|Number of patients|
|Isolated organism||Number of patients||Percentage|
|Therapeutic group||Number of patients||Percentage|
|Ofloxacin -Ornidazole (A)||620||59.6|
|Clinical presentation||Number of patients|
|Group A||Group B||Group C|
|Abdominal distension /heaviness||402||7||-|
|Dryness of mouth||578||3||01|
|Characteristics||Number of patients|
|Group A||Group B||Group C|
|Duration required for|
|Change in faecal matter Consistency||24 Hrs||30 Hrs||36 Hrs|
|Diarrhoea persistence||3-4 days||-||-|
|Post therapy stool status|
|Positive for pathogen||40%||-||-|
|Needed fluid & electrolyte|
|Post diarrheal mucous colitis||30%||None||None|
|Post therapy Urine status|
|Status of bio parameter:|
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