Prevention and treatment of infectious diarrhea. Speculations on the next 10 years

Abstract

The next decade should explode with exciting schemes and novel agents for the prevention and treatment of infectious diarrhea. The development of oral, nonabsorbed antibiotics will continue, but new antidiarrheal drugs, such as gastrointestinal hormone analogues and alpha-adrenergic agonists, will be added to our therapeutic armamentarium. Improved oral rehydration solutions, such as glycine in electrolyte solution, promise to revolutionize the management of diarrhea by diminishing diarrheal stool volume to the point where losses are too small to be clinically relevant. Infant formulas and adult oral solutions fortified with antibodies raised against selected enteropathogens may provide a way to prevent infectious diarrheas in infants and travelers. Advances in genetic engineering will usher in a new era of experimental and licensed enteric vaccines, including those against cholera, Escherichia coli, Shigella, typhoid fever, and rotavirus.