special subjects
Foreign Travel
Traveler’s diarrhea
 Traveler’s Diarrhea (TD) is the most common health problem among international travelers. TD is usually self-limited, typically resolving in 5 days; however, 3 to 10% of travelers with TD may have symptoms lasting Self-initiated treatment is indicated for moderate to severe symptoms, especially if vomiting, fever, abdominal cramps, or blood in the stool are present. Treatment is with an appropriate antibiotic (eg, Measures that may decrease the risk of TD include Drinking and brushing teeth with bottled, filtered, boiled, or chlorinated water Avoiding ice Eating freshly prepared foods only if they have been heated to steaming temperatures Eating only fruits and vegetables that travelers peel or shell themselves Avoiding food from street vendors Washing hands frequently Avoiding all foods likely to have been exposed to flies Prophylactic antibiotics are effective in preventing diarrhea, but because of concerns about adverse effects and development of resistance, they should probably be reserved for immunocompromised patients. One option isrifaximin, 200 mg once or twice a day. 