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Traveler's diarrhea.

Johnnie Yates1

  • 1CIWEC Clinic Travel Medicine Center, Kathmandu, Nepal.

American Family Physician
|June 15, 2005
PubMed
Summary

Traveler's diarrhea, often caused by contaminated food and water, affects millions annually. Antibiotic treatment is effective, with specific drugs recommended based on geographic location and common pathogens.

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Area of Science:

  • Infectious Diseases
  • Travel Medicine
  • Microbiology

Background:

  • Millions of travelers experience acute diarrhea annually, primarily in developing countries.
  • Contaminated food and water are the main sources of infection, with bacteria like E. coli, Salmonella, and Shigella being common culprits.
  • While parasites and viruses can cause diarrhea, bacterial infections are more prevalent.

Purpose of the Study:

  • To review the causes, risk factors, and treatment of traveler's diarrhea.
  • To discuss the efficacy of various treatment options, including antibiotics and loperamide.
  • To provide guidance on selecting appropriate antimicrobial agents based on geographic location and causative pathogens.

Main Methods:

  • Review of existing literature on traveler's diarrhea.
  • Analysis of common bacterial, parasitic, and viral etiologies.
  • Evaluation of treatment guidelines and drug efficacy.

Main Results:

  • Travel destination is the most significant risk factor for traveler's diarrhea.
  • Pretravel counseling and dietary precautions have unproven efficacy in prevention.
  • Empiric antibiotic treatment, often with loperamide, is effective in limiting symptoms to one day.
  • Rifaximin is suitable for regions with noninvasive E. coli; fluoroquinolones are preferred for invasive pathogens like Campylobacter and Shigella.
  • Azithromycin is recommended for quinolone-resistant Campylobacter and for pediatric or pregnant patients.

Conclusions:

  • Traveler's diarrhea is a common ailment with identifiable causes and effective treatment options.
  • Antibiotic selection for traveler's diarrhea should be guided by regional epidemiology of pathogens.
  • Further research may be needed to establish the efficacy of preventive measures.

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