Update on Traveler's Diarrhea.
Allen C. Cheng1, Nathan M. Thielman
1Room 0376, Orange Zone, Box 3152, Duke South, Division of Infectious Diseases, Duke University Medical Center, Durham, NC 27710, USA. n.thielman@duke.edu
Current Infectious Disease Reports
|February 21, 2002
Summary
Traveler's diarrhea, often caused by bacteria like E. coli, is a common issue. While hydration and antibiotics like fluoroquinolones are key, emerging resistance necessitates exploring alternatives such as azithromycin for effective treatment.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Travel Medicine
Background:
- Traveler's diarrhea is a prevalent health concern for international travelers.
- Enterotoxigenic Escherichia coli is a common cause, but enteroaggregative E. coli is increasingly recognized.
- Other pathogens include Shigella, Campylobacter, Salmonella, and intestinal protozoa, causing acute or protracted diarrhea.
Purpose of the Study:
- To review the common causes, prevention strategies, and treatment options for traveler's diarrhea.
- To highlight the challenges in behavioral modification for prevention.
- To discuss emerging therapeutic agents and the impact of antimicrobial resistance.
Main Methods:
- Literature review of common pathogens and clinical presentations.
- Analysis of current prevention strategies, including education and potential vaccines.
- Evaluation of symptomatic treatments and antimicrobial therapies.
Main Results:
- Enterotoxigenic E. coli and enteroaggregative E. coli are significant pathogens.
- Hydration is critical, especially for children.
- Fluoroquinolones are effective for severe cases, but resistance is a growing concern, particularly for Campylobacter infections.
- Newer agents like zaldaride maleate and racecadotril are under development for symptom relief.
Conclusions:
- Effective treatment options exist, with fluoroquinolones being a primary choice for severe traveler's diarrhea.
- Antimicrobial resistance necessitates exploring alternative treatments like azithromycin and rifaximin.
- While education is crucial for prevention, its effectiveness is limited by behavioral challenges.
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