Travel to Developing Countries - Traveler's Diarrhea

Parasites do not usually respond to standard antibiotics. Trimethoprim-sulfamethoxazole (Bactrim), for example, has fallen out of favor for routine use because of resistant bacteria, but it may be very effective against the severe diarrhea caused by the parasite Cyclospora. Metronidazole (Flagyl) is the standard drug for Giardia. Erythromycin and similar antibiotics may be useful for Cryptosporidium or Campylobacter. Nitazoxanide is another antibiotic showing promise for treating diarrhea caused by parasites. Antibiotics do not work for diarrhea caused by viruses.

Experimental Drugs. Racecadotril (Tiorfan), also called acetorphan, reduces water and electrolyte loss in the intestine. Studies report that the drug is safe and effective although it must be used in combination with rehydration solutions. Comparison studies suggest that racecadotril is equal to or only slightly less effective then loperamide (Imodium) and causes less constipation and bloating. Racecadotril also seems to be safe in small children, while Imodium should not be used in this population. Racecadotril may not be effective against certain parasites such as Cryptosporidium.

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