human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To compare the clinical and bacteriological success of single dose treatment with azithromycin and ciprofloxacin in children with cholera . Design R and omized , open labelled , clinical controlled trial . Setting Tertiary care hospital . Participants 180 children between 2–12 years , having watery diarrhea for ≤24 hr and severe dehydration , who tested positive for Vibrio cholerae by hanging drop examination or culture of stool . InterventionAzithromycin 20 mg/kg single dose ( n=91 ) or Ciprofloxacin 20 mg/kg single dose ( n=89 ) . Dehydration was managed according to WHO guidelines .Main outcome measures Clinical success ( resolution of diarrhea within 24 hr ) and bacteriological success ( cessation of excretion of Vibrio cholerae by day 3 ) . Secondary outcome variables included duration of diarrhea , duration of excretion of Vibrio cholerae in stool , fluid requirement , and proportion of children with clinical or bacteriological relapse . Results The rate of clinical success was 94.5 % ( 86/91 ) in children treated with Azithromycin and 70.7 % ( 63/89 ) in those treated with Ciprofloxacin [ RR ( 95 % CI)=1.34 ( 1.16–1.54 ) ; P<0.001 ] . Bacteriological success was documented in 100 % ( 91/91 ) children in Azithromycin group compared to 95.5 % ( 85/89 ) in Ciprofloxacin group [ RR ( 95 % CI)=1.05 ( 1.00–1.10 ) ; P=0.06 ] . Patients treated with Azithromycin had a shorter duration of diarrhea [ mean(SD ) 54.6 ( 18.6 ) vs 71.5 ( 29.6 ) h ; mean difference ( 95 % CI ) 16.9 ( 9.6–24.2 ) ; P<0.001 ] and lesser duration of excretion of Vibrio cholerae [ mean(SD ) 34.6 ( 16.3 ) vs 52.1 ( 29.2 ) h ; mean difference ( 95 % CI ) 17.5 ( 0.2–24.7 ) , P<0.001 ] in children treated with Azithromycin vs Ciprofloxacin . The amount of intravenous fluid requirement was significantly less among subjects who received Azithromycin as compared to those who received Ciprofloxacin [ mean(SD ) 4704.7(2188.4 ) vs 3491.1(1520.5 ) mL ; Mean difference ( 95 % CI ) 1213(645.3–1781.9 ) ; P<0.001 ] . Proportion of children with bacteriological relapse was comparable in two groups [ 6.7 % ( 6/89 ) vs 2.2 % ( 2/91 ) ; RR ( 95 % CI ) 0.95 ( 0.89–1.01 ) ; P=0.16 ] . None of the children in either group had a clinical relapse . ConclusionS ingle dose azithromycin is superior to ciprofloxacin for treating cholera in children OBJECTIVE --To compare the efficacy of a single dose of doxycycline ( 200 or 300 mg ) with the st and ard multiple doses of tetracycline in patients with cholera . DESIGN --R and omised double blind controlled trial . Patients were given a single 200 mg dose of doxycycline , a single 300 mg dose of doxycycline , or multiple doses of tetracycline ( 500 mg , six hourly intervals ) . SETTING --Hospital in Bangladesh treating diarrhoea . PATIENTS --261 Patients aged over 15 admitted to the hospital with severe dehydration due to acute watery diarrhoea associated with Vibrio cholerae . All vibrios isolated from the stools and rectal swabs of patients , including those patients with prolonged excretion of vibrios , were sensitive to tetracycline . The stools of all patients at admission were negative for shigella and salmonella . INTERVENTIONS --All patients received rapid intravenous acetate solution for the first four hours after admission to hospital . They were then entered in the study and r and omised . Oral rehydration was started immediately after the intravenous treatment . If signs of severe dehydration reappeared during oral treatment patients were given rapid intravenous acetate solution until dehydration was fully corrected . MAIN OUTCOME MEASURES --Stool output in first 24 hours and till diarrhoea stopped , total intake of oral rehydration fluid , duration of diarrhoea , and excretion of vibrio after receiving antibiotic treatment . RESULTS --The median stool outputs during the first 24 hours ( 275 ml/kg body weight ) and till diarrhoea stopped ( 296 ml/kg body weight ) were significantly higher in patients receiving 200 mg doxycycline as a single dose than in patients receiving either st and ard tetracycline ( 242 ml/kg body weight and 254 ml/kg body weight ) or 300 mg doxycycline ( 226 ml/kg body weight and 255 ml/kg body weight ) . Similarly , median consumption of oral rehydration solution ( 18.45 l ) was significantly higher in patients receiving 200 mg doxycycline than in patients receiving either 300 mg doxycycline ( 16.10 l ) or st and ard tetracycline ( 14.80 l ) . Almost equal numbers of patients in each group required unscheduled intravenous acetate solution to correct dehydration during antibiotic treatment . Patients treated with doxycycline ( low or high dose ) , however , had more prolonged excretion of bacteria . CONCLUSIONS --A single 300 mg dose of doxycycline is as effective as the st and ard multiple dose tetracycline treatment for cholera in terms of stool output , duration of diarrhoea , vomiting , and requirement for oral rehydration solution BACKGROUND Single-dose azithromycin is effective in the treatment of severe cholera in children , but its effectiveness in adults has not been evaluated . METHODS We conducted a double-blind , r and omized trial comparing the equivalence of azithromycin and ciprofloxacin ( each given in a single 1-g dose of two 500-mg tablets ) among 195 men with severe cholera caused by Vibrio cholerae O1 or O139 . Patients were hospitalized for five days . A stool culture was performed daily . Primary outcome measures were clinical success ( the cessation of watery stools within 48 hours after drug administration ) and bacteriologic success ( the inability to isolate V. cholerae after 48 hours ) . RESULTS Therapy was clinical ly successful in 71 of 97 patients receiving azithromycin ( 73 percent ) and in 26 of 98 patients receiving ciprofloxacin ( 27 percent ) ( P<0.001 ) and bacteriologically successful in 76 of 97 patients receiving azithromycin ( 78 percent ) and in 10 of 98 patients receiving ciprofloxacin ( 10 percent ) ( P<0.001 ) . Patients who were treated with azithromycin had a shorter duration of diarrhea than did patients treated with ciprofloxacin ( median , 30 vs. 78 hours ) ; a lower frequency of vomiting ( 43 percent vs. 67 percent ) ; fewer stools ( median , 36 vs. 52 ) ; and a lower stool volume ( median , 114 vs. 322 ml per kilogram of body weight ) . The median minimal inhibitory concentration of ciprofloxacin for the 177 isolates of V. cholerae O1 was 0.25 mug per milliliter , which was 11 to 83 times as high as that in previous studies at this site . CONCLUSIONS Single-dose azithromycin was effective in the treatment of severe cholera in adults . The lack of efficacy of ciprofloxacin may result from its diminished activity against V. cholerae O1 strains currently circulating in Bangladesh . ( Clinical Trials.gov number , NCT00229944 . ) Serotyping of Vibrio cholerae is based on the somatic ' 0 ' antigen . Cholera is caused by the 01 serotype ev . cholerae 01 ) , and there were pre­ viously a total of 138 serotypes identified . A new serotype of V. cholerae has recently been identified as the pathogen responsible for explosive outbreaks of severe dehydrating diarrhoea in India and Bangladesh . This has been design ated V. cholerae 0139 . [ 1 ] Since it produces an illness that is clinical ly indistinguishable from cholera , it is considered to be another serotype of V. cholerae that can cause cholera.[2 ] The synonym ' Bengal ' has been proposed because the serotype was first isolated along the Bay of Bengal . Replacement of fluid and electrolyte losses is the most important part of tbe management of patients with cholera caused by V. cholerae 01 or V. cholerae 0139 . Treatment of cholera due to V. cholerae 01 with effective antimicrobials has been useful in shortening the duration of diarrhoea and faecal excretion of the pathogen , and in reduc­ ing the volume of watery stools , with subsequent decreased requirement for rehydration fluids . This r and omised clinical trial was conducted at the Diarrhoea Treatment Centre of the A controlled comparison of furazolidone and tetracycline in the treatment of cholera indicates that , in either dosage used , furazolidone reduced total stool volume by 50 % and duration of diarrhoea by 40 % . These results are comparable to those achieved with tetracycline , which was given in presently recommended dosage . Both furazolidone and tetracycline significantly reduced the rate of stool output within 18 to 24 hours of starting antibiotic treatment . Furazolidone was significantly less effective than tetracycline in rapidly and consistently terminating vibrio excretion . One convalescent carrier of  cholera vibrios was identified among control patients ; none was identified among patients treated with either tetracycline or furazolidone .  All Vibrio cholerae strains tested were sensitive to tetracycline and furazolidone , but larger concentrations of the latter were required to achieve inhibition of growth . It is concluded that tetracycline remains the antibiotic of choice in cholera but that furazolidone would be a useful adjunct to cholera therapy when tetracycline is unobtainable or if strains of V. cholerae with clinical ly significant resistance to tetracycline should be encountered BACKGROUND Single-dose ciprofloxacin is effective for the treatment of severe cholera in adults . We assessed whether single-dose ciprofloxacin would be as effective as 3-day , 12-dose erythromycin in achieving clinical cure in children with severe cholera . METHODS We did a r and omised , open label , controlled trial in children age 2 - 15 years with V cholerae O1 or O139 present in stool on dark-field microscopy . Children received either a single 20 mg/kg dose of ciprofloxacin ( n=90 ) or 12.5 mg/kg of erythromycin ( n=90 ) every 6 h for 3 days , and remained in hospital for 5 days . The primary outcome was clinical success of treatment , defined as cessation of watery stools within 48 h of start of drug treatment . Analysis was per protocol . This study is registered with the Clinical Trials.gov Protocol Registration System at http://www . clinical trials.gov ( registration number NCT 00142272 ) [ corrected ] FINDINGS Of 180 children r and omised 162 completed the study .  Treatment was clinical ly successful in 60 % ( 47/78 ) of children treated with ciprofloxacin and in 55 % ( 46/84 ) of those treated with erythromycin ( difference 5 % [ 95 % CI -10 to 21 ] ) . Children receiving ciprofloxacin  vomited less often ( 58%vs 74 % ; difference 16 % [ 2 to 30 ] ) , had fewer stools ( 15 vs 21 ; 6 [ 0 to 9 ] ) , and less stool volume ( 152 vs 196 mL/kg ; 43 mL/kg [ 13 to 87 ] ) than those receiving erythromycin .  Bacteriological failure was more common in ciprofloxacin-treated patients ( 58%vs 30 % ; 28 % [ 13 to 43 ] ) than erythromycin-treated patients . INTERPRETATION Single-dose ciprofloxacin achieves clinical outcomes similar to , 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To compare the clinical and bacteriological success of single dose treatment with azithromycin and ciprofloxacin in children with cholera . Design R and omized , open labelled , clinical controlled trial . Setting Tertiary care hospital . Participants 180 children between 2–12 years , having watery diarrhea for ≤24 hr and severe dehydration , who tested positive for Vibrio cholerae by hanging drop examination or culture of stool . InterventionAzithromycin 20 mg/kg single dose ( n=91 ) or Ciprofloxacin 20 mg/kg single dose ( n=89 ) . Dehydration was managed according to WHO guidelines .Main outcome measures Clinical success ( resolution of diarrhea within 24 hr ) and bacteriological success ( cessation of excretion of Vibrio cholerae by day 3 ) . Secondary outcome variables included duration of diarrhea , duration of excretion of Vibrio cholerae in stool , fluid requirement , and proportion of children with clinical or bacteriological relapse . Results The rate of clinical success was 94.5 % ( 86/91 ) in children treated with Azithromycin and 70.7 % ( 63/89 ) in those treated with Ciprofloxacin [ RR ( 95 % CI)=1.34 ( 1.16–1.54 ) ; P<0.001 ] . Bacteriological success was documented in 100 % ( 91/91 ) children in Azithromycin group compared to 95.5 % ( 85/89 ) in Ciprofloxacin group [ RR ( 95 % CI)=1.05 ( 1.00–1.10 ) ; P=0.06 ] . Patients treated with Azithromycin had a shorter duration of diarrhea [ mean(SD ) 54.6 ( 18.6 ) vs 71.5 ( 29.6 ) h ; mean difference ( 95 % CI ) 16.9 ( 9.6–24.2 ) ; P<0.001 ] and lesser duration of excretion of Vibrio cholerae [ mean(SD ) 34.6 ( 16.3 ) vs 52.1 ( 29.2 ) h ; mean difference ( 95 % CI ) 17.5 ( 0.2–24.7 ) , P<0.001 ] in children treated with Azithromycin vs Ciprofloxacin . The amount of intravenous fluid requirement was significantly less among subjects who received Azithromycin as compared to those who received Ciprofloxacin [ mean(SD ) 4704.7(2188.4 ) vs 3491.1(1520.5 ) mL ; Mean difference ( 95 % CI ) 1213(645.3–1781.9 ) ; P<0.001 ] . Proportion of children with bacteriological relapse was comparable in two groups [ 6.7 % ( 6/89 ) vs 2.2 % ( 2/91 ) ; RR ( 95 % CI ) 0.95 ( 0.89–1.01 ) ; P=0.16 ] . None of the children in either group had a clinical relapse . ConclusionS ingle dose azithromycin is superior to ciprofloxacin for treating cholera in children OBJECTIVE --To compare the efficacy of a single dose of doxycycline ( 200 or 300 mg ) with the st and ard multiple doses of tetracycline in patients with cholera . DESIGN --R and omised double blind controlled trial . Patients were given a single 200 mg dose of doxycycline , a single 300 mg dose of doxycycline , or multiple doses of tetracycline ( 500 mg , six hourly intervals ) . SETTING --Hospital in Bangladesh treating diarrhoea . PATIENTS --261 Patients aged over 15 admitted to the hospital with severe dehydration due to acute watery diarrhoea associated with Vibrio cholerae . All vibrios isolated from the stools and rectal swabs of patients , including those patients with prolonged excretion of vibrios , were sensitive to tetracycline . The stools of all patients at admission were negative for shigella and salmonella . INTERVENTIONS --All patients received rapid intravenous acetate solution for the first four hours after admission to hospital . They were then entered in the study and r and omised . Oral rehydration was started immediately after the intravenous treatment . If signs of severe dehydration reappeared during oral treatment patients were given rapid intravenous acetate solution until dehydration was fully corrected . MAIN OUTCOME MEASURES --Stool output in first 24 hours and till diarrhoea stopped , total intake of oral rehydration fluid , duration of diarrhoea , and excretion of vibrio after receiving antibiotic treatment . RESULTS --The median stool outputs during the first 24 hours ( 275 ml/kg body weight ) and till diarrhoea stopped ( 296 ml/kg body weight ) were significantly higher in patients receiving 200 mg doxycycline as a single dose than in patients receiving either st and ard tetracycline ( 242 ml/kg body weight and 254 ml/kg body weight ) or 300 mg doxycycline ( 226 ml/kg body weight and 255 ml/kg body weight ) . Similarly , median consumption of oral rehydration solution ( 18.45 l ) was significantly higher in patients receiving 200 mg doxycycline than in patients receiving either 300 mg doxycycline ( 16.10 l ) or st and ard tetracycline ( 14.80 l ) . Almost equal numbers of patients in each group required unscheduled intravenous acetate solution to correct dehydration during antibiotic treatment . Patients treated with doxycycline ( low or high dose ) , however , had more prolonged excretion of bacteria . CONCLUSIONS --A single 300 mg dose of doxycycline is as effective as the st and ard multiple dose tetracycline treatment for cholera in terms of stool output , duration of diarrhoea , vomiting , and requirement for oral rehydration solution BACKGROUND Single-dose azithromycin is effective in the treatment of severe cholera in children , but its effectiveness in adults has not been evaluated . METHODS We conducted a double-blind , r and omized trial comparing the equivalence of azithromycin and ciprofloxacin ( each given in a single 1-g dose of two 500-mg tablets ) among 195 men with severe cholera caused by Vibrio cholerae O1 or O139 . Patients were hospitalized for five days . A stool culture was performed daily . Primary outcome measures were clinical success ( the cessation of watery stools within 48 hours after drug administration ) and bacteriologic success ( the inability to isolate V. cholerae after 48 hours ) . RESULTS Therapy was clinical ly successful in 71 of 97 patients receiving azithromycin ( 73 percent ) and in 26 of 98 patients receiving ciprofloxacin ( 27 percent ) ( P<0.001 ) and bacteriologically successful in 76 of 97 patients receiving azithromycin ( 78 percent ) and in 10 of 98 patients receiving ciprofloxacin ( 10 percent ) ( P<0.001 ) . Patients who were treated with azithromycin had a shorter duration of diarrhea than did patients treated with ciprofloxacin ( median , 30 vs. 78 hours ) ; a lower frequency of vomiting ( 43 percent vs. 67 percent ) ; fewer stools ( median , 36 vs. 52 ) ; and a lower stool volume ( median , 114 vs. 322 ml per kilogram of body weight ) . The median minimal inhibitory concentration of ciprofloxacin for the 177 isolates of V. cholerae O1 was 0.25 mug per milliliter , which was 11 to 83 times as high as that in previous studies at this site . CONCLUSIONS Single-dose azithromycin was effective in the treatment of severe cholera in adults . The lack of efficacy of ciprofloxacin may result from its diminished activity against V. cholerae O1 strains currently circulating in Bangladesh . ( Clinical Trials.gov number , NCT00229944 . ) Serotyping of Vibrio cholerae is based on the somatic ' 0 ' antigen . Cholera is caused by the 01 serotype ev . cholerae 01 ) , and there were pre­ viously a total of 138 serotypes identified . A new serotype of V. cholerae has recently been identified as the pathogen responsible for explosive outbreaks of severe dehydrating diarrhoea in India and Bangladesh . This has been design ated V. cholerae 0139 . [ 1 ] Since it produces an illness that is clinical ly indistinguishable from cholera , it is considered to be another serotype of V. cholerae that can cause cholera.[2 ] The synonym ' Bengal ' has been proposed because the serotype was first isolated along the Bay of Bengal . Replacement of fluid and electrolyte losses is the most important part of tbe management of patients with cholera caused by V. cholerae 01 or V. cholerae 0139 . Treatment of cholera due to V. cholerae 01 with effective antimicrobials has been useful in shortening the duration of diarrhoea and faecal excretion of the pathogen , and in reduc­ ing the volume of watery stools , with subsequent decreased requirement for rehydration fluids . This r and omised clinical trial was conducted at the Diarrhoea Treatment Centre of the A controlled comparison of furazolidone and tetracycline in the treatment of cholera indicates that , in either dosage used , furazolidone reduced total stool volume by 50 % and duration of diarrhoea by 40 % . These results are comparable to those achieved with tetracycline , which was given in presently recommended dosage . Both furazolidone and tetracycline significantly reduced the rate of stool output within 18 to 24 hours of starting antibiotic treatment . Furazolidone was significantly less effective than tetracycline in rapidly and consistently terminating vibrio excretion . One convalescent carrier of  cholera vibrios was identified among control patients ; none was identified among patients treated with either tetracycline or furazolidone .  All Vibrio cholerae strains tested were sensitive to tetracycline and furazolidone , but larger concentrations of the latter were required to achieve inhibition of growth . It is concluded that tetracycline remains the antibiotic of choice in cholera but that furazolidone would be a useful adjunct to cholera therapy when tetracycline is unobtainable or if strains of V. cholerae with clinical ly significant resistance to tetracycline should be encountered BACKGROUND Single-dose ciprofloxacin is effective for the treatment of severe cholera in adults . We assessed whether single-dose ciprofloxacin would be as effective as 3-day , 12-dose erythromycin in achieving clinical cure in children with severe cholera . METHODS We did a r and omised , open label , controlled trial in children age 2 - 15 years with V cholerae O1 or O139 present in stool on dark-field microscopy . Children received either a single 20 mg/kg dose of ciprofloxacin ( n=90 ) or 12.5 mg/kg of erythromycin ( n=90 ) every 6 h for 3 days , and remained in hospital for 5 days . The primary outcome was clinical success of treatment , defined as cessation of watery stools within 48 h of start of drug treatment . Analysis was per protocol . This study is registered with the Clinical Trials.gov Protocol Registration System at http://www . clinical trials.gov ( registration number NCT 00142272 ) [ corrected ] FINDINGS Of 180 children r and omised 162 completed the study .  Treatment was clinical ly successful in 60 % ( 47/78 ) of children treated with ciprofloxacin and in 55 % ( 46/84 ) of those treated with erythromycin ( difference 5 % [ 95 % CI -10 to 21 ] ) . Children receiving ciprofloxacin  vomited less often ( 58%vs 74 % ; difference 16 % [ 2 to 30 ] ) , had fewer stools ( 15 vs 21 ; 6 [ 0 to 9 ] ) , and less stool volume ( 152 vs 196 mL/kg ; 43 mL/kg [ 13 to 87 ] ) than those receiving erythromycin .  Bacteriological failure was more common in ciprofloxacin-treated patients ( 58%vs 30 % ; 28 % [ 13 to 43 ] ) than erythromycin-treated patients . INTERPRETATION Single-dose ciprofloxacin achieves clinical outcomes similar to , 
    Output:
    