The incidence of TD was assumed to be 8 in low risk areas (Europe, Canada, Australia, New Zealand and USA), 15 in intermediate risk areas (Israel, Japan, South Africa, the Caribbean, the Mediterranean, Pacific Islands, China and the Commonwealth of Independent States) and 56% in high risk areas (Asia, Africa and Latin America). The assumed rate of efficacy for prophylaxis with doxycycline 100 mg per day was 75%; with ciprofloxacin 500mg per day, 95%; and with cotrimoxazole (trimethoprim-sulfamethoxazole) 160 mg/800mg per day, 95%.
The standard treatment was cotrimoxazole 160mg/800mg twice daily begun early in the disease, which decreases symptom severity and duration regardless of pathogen. Ciprofloxacin 500mg twice daily is effective, whereas the single dose option showed a shortening of symptom duration from 53.5 hours to 25 hours. The 250 mg twice daily option of the same drug for three days, showed a good symptomatic effect. Doxycycline 100 mg daily was found to be subject to the risk of limited usefulness because of microbial resistance (all assumptions werebased on results from the review).