Pharmacists' self-medication for the travelers' diarrhea

Visitors to developing areas of the world are at high risk for contracting travelers' diarrhea (TD). Despite proven effectiveness in the prevention of TD, prophylactic use of anti-diarrheal agents is controversial. Most authorities recommend against the routine use of drugs for the prevention of TD. This article presents data from surveys of pharmacists and their spouses participating in vacation-study tours to countries associated with a high risk of TD. Patterns of antidiarrheal drug use are compared with the recommended practices regarding both prophylactic and symptomatic therapy. Generally, the subjects in this study adhered closely to recommended practices. Nevertheless, although a majority employed dietary restrictions for TD prevention, 22.8 percent took antidiarrheal drugs prophylactically. Nearly half took antidiarrheal agents for symptomatic use. The ingredients most frequently mentioned matched current recommendations. Inappropriate practices included the use of prophylactic agents without dietary restrictions, and the use of antimotility agents prophylactically. Patterns of dietary and antidiarrheal drug use are compared, including intended versus actual, prophylactic versus symptomatic, and prescription versus nonprescription product use. The controversy regarding the use of prophylactic drug therapy for TD is discussed.