There is insufficient evidence for the use of antimotility agents and adsorbents in controlling diarrhoea in people with HIV/AIDS.
A Cochrane review 1 included 1 study with a total of 91 subjects. The trial including patients from African French speaking countries assessed the use of an adsorbent (attapulgite) compared to a placebo for chronic diarrhoea in people with HIV/AIDS experiencing diarrhoea for at least 7 days. There was no evidence that attapulgite is superior to placebo in controlling diarrhoea by reducing stool frequency and normalising stool consistency on days 1 (RR 0.34 95% CI 0.01 to 8.15), 3 (RR 1.35 95% CI 0.51 to 3.62) and 5 (RR 1.74 95% CI 0.89 to 3.38). Five deaths were reported which was not classified according to the arms of the study. Studies assessing the use of antimotility agents were not found.
Comment: The quality of evidence is downgraded by study quality (several issues) and by imprecise results (few patients and wide confidence intervals).
1. Nwachukwu CE, Okebe JU. Antimotility agents for chronic diarrhoea in people with HIV/AIDS. Cochrane Database Syst Rev. 2008;(4):CD005644
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"Adsorbents for Chronic Diarrhoea in People With HIV/AIDS." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/453080/all/Adsorbents_for_chronic_diarrhoea_in_people_with_HIV_AIDS.
Adsorbents for chronic diarrhoea in people with HIV/AIDS. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/453080/all/Adsorbents_for_chronic_diarrhoea_in_people_with_HIV_AIDS. Accessed May 13, 2021.
Adsorbents for chronic diarrhoea in people with HIV/AIDS. (2019). In Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited. https://evidence.unboundmedicine.com/evidence/view/EBMG/453080/all/Adsorbents_for_chronic_diarrhoea_in_people_with_HIV_AIDS
Adsorbents for Chronic Diarrhoea in People With HIV/AIDS [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2021 May 13]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/453080/all/Adsorbents_for_chronic_diarrhoea_in_people_with_HIV_AIDS.
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