Travel to Developing Countries - Traveler's Diarrhea

Prophylactic Antibiotics. Prophylactic antibiotic regimens are those that are used to prevent diarrhea while traveling. They work well but there are many reasons that warrant against their routine use. Taking prophylactic antibiotics can trigger adverse drug reactions, development of superinfections, and can contribute to the widespread bacterial resistance to many antibiotics. Antibiotics are also not effective against parasites or viruses and may give travelers a sense of false security. At this time, prophylactic antibiotics are therefore not generally recommended. However, researchers are studying whether prophylactic antibiotics should be used more often. In a 2005 study of travelers to Mexico, 15% of patients who took preventive doses of rifaximin (Xifaxan) developed traveler?s diarrhea compared to 54% of patients who received placebo. Rifaximin is an antibiotic that was approved in 2004 for treatment of traveler?s diarrhea caused by E. coli.

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Lactobacilli. Taking capsules that contain protective bacteria called lactobacilli (also called probiotics), may be helpful. Some studies report that a genetically engineered strain called Lactobacillus rhamnosus strain GG may prevent and reduce severity of diarrhea. In fact, lactobacilli may be used for both prevention and treatment in children without any adverse effects. The capsules can be split open and put into beverages for small children.

Treatment for Diarrhea

Fluid Replacement. If diarrhea develops, prevention of dehydration is the most important first step. In severe cases, dehydration can be life threatening, particularly in children. Agitation may be an early symptom. Severe indications include listlessness and a weak pulse. Parents should seek medical help immediately if the child appears to be dehydrated.

Fluid replacement must use solutions that contain the important minerals potassium, sodium, and calcium. The following are some suggestions:

A recipe that is useful for fluid replacement calls for two glasses of fluid: the first containing 8 oz. of fruit juice, 1/2 tsp. of honey or corn syrup, and a pinch of salt; the second filled with 8 oz. of purified or carbonated water and 1/4 tsp. of baking soda. The traveler should drink alternately from each glass until the thirst is quenched.
Parents with small children should bring commercial oral rehydration solutions such as Pedialyte, Lytren, Gastrolyte, or Ricelyte. Products containing rice flour work slightly faster than others. If the child finds the taste unpleasant, adding a half-teaspoon of Jell-O or Kool Aid to sweeten the solution does not appear to reduce its benefits.
Adding a soluble fiber supplement and eating as soon as possible helps the intestine to absorb water and is beneficial for children and adults.
Children with diarrhea should not drink apple juice, colas, or sports beverages, which do not contain the proper balance of salts and sugar.