Comparison of glucose/electrolyte and maltodextrin/glycine/glycyl-glycine/electrolyte oral rehydration solutions in cholera and watery diarrhoea in adults

Abstract

One hundred and eight male adults (mean age 33 ± 1·7 years) presenting with watery diarrhoea of less than 48 hours duration at home prior to hospitalization and with clinically evident (grade II, severe) dehydration were admitted into a randomized double-blind clinical trial; 54 were treated with standard oral rehydration solution (ORS)—WHO formulation containing citrate—and 54 with an improved ORS formulation which contained, in addition to the standard formula, maltodextrin 20 g (instead of glucose), glycine 4 g and glycyl-glycine 4 g. Patients with clinical cholera were given tetracycline 500 mg q.i.d. Vibrio cholerae was detected in 85 patients. The clinical characteristics of patients in the two groups were comparable.

The improved ORS did not reduce the volume of diarrhoeic stools in cholera; indeed, patients with cholera who were treated with improved ORS had larger diarrhoea stool volumes. However, those cholera patients given improved ORS showed significantly greater weight gains during the first six-hour period, at the end of the second day, and at discharge. On the other hand, non-cholera patients treated with improved ORS had significantly smaller diarrhoeic stool volumes during the six to 24-hour period (i.e. during the commencement of maintenance rehydration therapy).