Saccharomyces boulardii and bismuth subsalicylate as low-cost interventions to reduce the duration and severity of cholera.

We conducted a randomised single-blinded clinical trial of 100 cholera patients in Port-au-Prince, Haiti to determine if the probiotic Saccharomyces cerevisiae var. boulardii and the anti-diarrhoeal drug bismuth subsalicylate (BS) were able to reduce the duration and severity of cholera. Subjects received either: S. boulardii 250 mg, S. boulardii 250 mg capsule plus BS 524 mg tablet, BS 524 mg, or two placebo capsules every 6 hours alongside standard treatment for cholera. The length of hospitalisation plus the number and volume of emesis, stool and urine were recorded every 6 hours until the study subject was discharged (n = 83), left against medical advice (n = 11), or requested removal from the study (n = 6). There were no reported deaths or adverse study-related events. There were no statistically significant differences between the study arms and the outcomes of interest.

Ivermectin causes Cimex lectularius (bedbug) morbidity and mortality.

BACKGROUND: Bedbug infestations are increasing across North America and Europe, with more people presenting to Emergency Departments for treatment. Physicians cannot provide substantive treatment for people affected by bedbugs. STUDY OBJECTIVE: To determine if ivermectin, a relatively inexpensive and safe, long-acting oral anti-parasitic drug is able to cause bedbug morbidity and mortality. METHODS: We evaluated the effects of ivermectin on bedbugs using an artificial feeding membrane and mice and humans. Bedbug morbidity, mortality, and nymph molting was recorded. RESULTS: Using an artificial feeding membrane, bedbug mortality was 98% (n = 81) for 260 ng/mL ivermectin and 0% for 0 ng/mL ivermectin (control; n = 90) after 13 days. Mortality for bedbugs fed on mice injected with the human equivalent of 200 µg/kg ivermectin was 86% (n = 22), vs. 0% in the 0 µg/kg ivermectin (control; n = 21). Of the surviving nymphs, 0% exposed to ivermectin molted by day 75, vs. 80% in the control group by day 8. Bedbugs that fed once on human study subjects 3 h after consuming 200 µg/kg of oral ivermectin had a 63% (n = 24) 20-day mortality rate, vs. 8% (n = 24) in the control group. Of the surviving nymphs, 0% (n = 5) in the 3-h ivermectin group molted, vs. 80% (n = 10) of the control group. CONCLUSIONS: It may be possible that ivermectin could help eradicate, suppress, or prevent a bedbug infestation.