Nanyuki

Researchers are evaluating a single dose of rifaximin combined with loperamide compared to the current standard treatment of a single dose of azithromycin with loperamide for acute watery traveler's diarrhea. This phase 4 randomized controlled trial aims to compare the effectiveness of these two antibiotic treatments alongside loperamide in managing this condition. Participants are active duty military members aged 18 to 60 experiencing recent acute watery diarrhea that affects their daily activities or duties. Participants will be randomly assigned to one of two treatment groups: one group will receive a single oral dose of rifaximin 550 mg with loperamide 4 mg initially, followed by 2 mg of loperamide after each loose stool; the other group will receive a single oral dose of azithromycin 500 mg with the same loperamide dosing schedule. Loperamide use is limited to a maximum of 16 mg per day for two days. Both treatments involve a single antibiotic dose plus loperamide used as needed. During the study, participants will provide blood and stool samples at various times to assess infection and immune responses. They will complete a daily symptom diary and be monitored by the study doctor to track illness and recovery. Additionally, participants will complete a brief electronic questionnaire three months after treatment. The main outcome measured is the therapeutic effectiveness of the antibiotic and loperamide combination within one week of treatment.