Researchers from the Naval Medical Research Center (NMRC) received the Military Health System Research Symposium (MHSRS) Team Award for Outstanding Research Accomplishment in the category of infectious disease, Aug. 17.

Capt. Mark Riddle, from NMRC, and his team were the recipients of the award in recognition of their role in successfully executing a multisite clinical trial to determine optimum drug therapy against traveler's diarrhea, which has been a leading cause of lost duty days for military personnel for more than 60 years.

Riddle was the coordinating principal investigator of the study entitled, "Trial Evaluating Antibiotic Treatment in Travelers' Diarrhea (TrEAT TD)."

Cmdr. Ramiro Gutierrez, head of the Enteric Diseases Department at NMRC, accepted the award on behalf of Riddle and the team. Gutierrez was an associate investigator on the study.

"Capt. Riddle is an internationally recognized leader in the field of traveler's diarrhea," said Gutierrez. "He has published extensively on the acute and chronic impacts to military personnel, the epidemiological characteristics, and the economic impacts these diseases cause. The idea for this study was something Capt. Riddle and his collaborators at the Uniformed Services University of the Health Sciences (USUHS) have been working on for some time."

The goal of the study was to test the efficacy of three single-dose antibiotic therapies on the ability to return deployed service members with debilitating diarrhea quickly back to duty. Working with multiple partners from locations around the globe, Riddle and his team were able to identify promising treatments by documenting high cure rates and rapid return to duty while minimizing antibiotic exposure.

Prior to this study, there were no well-developed clinical guidelines for the treatment of traveler's diarrhea among deployed personnel. However, the comprehensive research completed by Riddle and his team led to the development of the first evidence-based document, Deployment Health Guidelines on Management of Deployment Diarrhea to help clinicians treat patients with acute diarrhea. These guidelines will be prospectively integrated into education and training across Navy Medicine and the other military services to support improved force health protection by significantly reducing the number of lost duty days.

"When sick and in the field, the warfighter wants to feel better and get back to work as quickly as possible to do their job and support their mission," said NMRC Commanding Officer Capt. Jacqueline D. Rychnovsky. "The guidelines developed by Capt. Riddle and his team will assist medical providers to prescribe the most effective treatment possible using the fewest drugs at the lowest cost, enabling a quick return to duty with minimal side effects or other sequelae caused by long courses of antibiotics."

Riddle and his team coordinated their work with the Infectious Diseases Clinical Research Program at USUHS, the United Kingdom Ministry of Defense, and U.S. military overseas laboratories located in Peru, Egypt, Kenya, and Thailand.

Studies with single-dose treatments have been done in the past, according to Gutierrez, but TrEAT TD was the first to compare multiple antibiotics head to head in multiple geographic regions and included the relatively new antibiotic rifaximin as a single dose regimen.

Navy Medicine's research and development laboratories engage in a broad spectrum of activity from basic laboratory science to field studies at sites in remote areas of the world and in operational environments. Research topics include infectious diseases; biological warfare detection and defense; combat casualty care; environment health concerns; bone marrow research and registry; aerospace and undersea medicine; medical modeling, simulation and operational mission support; and epidemiology and behavioral sciences. The capabilities and global reach reflect the broad mission of Navy Medicine's Research and Development Enterprise.

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