Travel-Related Risk Behaviors and Antibiotic Use Among Older Travelers

Area of Science:

• Travel medicine
• Infectious diseases
• Geriatric medicine

Background:

• Antibiotic stewardship is crucial for older adults to manage infections and prevent harm from unnecessary antibiotic use.
• Pretravel care for older adults requires specific considerations regarding infection risks and antibiotic management.

Purpose of the Study:

• To compare characteristics, risk behaviors, infectious diseases, and antibiotic use between older (≥60 years) and younger (18-59 years) international travelers.
• To identify differences in health outcomes and healthcare utilization between these age groups.

Main Methods:

• Prospective, observational cohort study (TravMil) of US Department of Defense beneficiaries traveling internationally.
• Included adults aged 18-59 and ≥60 years, excluding active duty personnel on deployment.
• Collected pre and post-travel survey data on trip details, exposures, illnesses, and antibiotic use.

Main Results:

• Older travelers (≥60 years) were less likely to engage in high-risk behaviors and experience travelers' diarrhea compared to younger travelers (18-59 years).
• Influenza-like and febrile illnesses were less frequent in the older cohort.
• Inappropriate antibiotic self-treatment was common in both groups, particularly for mild symptoms like occasional loose stool or mild travelers' diarrhea.

Conclusions:

• Older adults are less prone to certain travel-related risks like travelers' diarrhea.
• Both age groups commonly misuse antibiotics for self-limiting conditions, underscoring the need for improved antimicrobial stewardship.
• Pretravel counseling should emphasize appropriate antibiotic use for international travelers of all ages.