Overusing Traveler's Diarrhea Antibiotics Can Be Avoided

Pharmacy travel counseling includes vaccines, antibiotics, and OTC products

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Each year, millions of international travelers visit countries with poor hygiene, and approximately 33 percent return home carrying antibiotic-resistant, intestinal bacteria.

According to a new study, the overuse of Travel Diarrhea (TD) antibiotics is one of the leading reasons.

When a person gets TD, they are infected with millions of bacteria, a few of which may be drug resistant. Under ordinary circumstances, “normal” bacteria compete with resistant bacteria for food and other resources, says the Centers for Disease Control and Prevention (CDC).

The resistant bacteria do not thrive because there are so few of them.

However, if the person takes antibiotics, the susceptible bacteria will die, allowing the resistant bacteria to grow and take over.

The person can then spread these resistant bacteria to other people.

As an example, Shigella sonnei bacteria was resistant to the antibiotic ciprofloxacin and sickened 243 people in 32 states between May 2014 and February 2015, reports the CDC. 

Shigella causes about 500,000 cases of diarrhea in the United States annually. 

These types of self-inflicted health issues can be easily avoided with some friendly medication advice from a nurse, doctor or pharmacist.

This study reported international travelers who bring antibiotics with them on a trip are more likely to use those antibiotics to treat Travelers Diarrhea (TD), even when the situation doesn't call for the use of antibiotics.

These researchers said that antibiotics used to be the mainstay of TD treatment. But the justification for this treatment approach has been questioned by health officials due to the upsurge in antimicrobial resistance.”

The study of 316 international travelers found those carrying travel diarrhea antibiotics took them 38 percent of the time, as compared to 4 percent who had to acquire TD antibiotics locally.

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And, bringing TD antibiotics while traveling did not to prevent medical visits when oversee.

On the contrary, bringing TD antibiotics encouraged more healthcare visits, 34 percent of the time, as compared to non TD antibiotic carriers, 11 percent.

For travelers to high-risk areas, several approaches may be recommended that can reduce, but never completely eliminate, the risk for acquiring a case of TD, says the CDC.

TD prevention tactics include instructions regarding food and beverage selection, using agents other than antimicrobial drugs for prophylaxis, using prophylactic antibiotics, and carefully washing hands with soap where available.

The leading CDC suggestion is to be selective where you eat.

Poor hygiene practice in local restaurants is likely the largest contributor to the risk for TD since bacteria are the most common cause of TD, says the CDC.

To clarify this issue, the International Society of Travel Medicine produced clinically relevant and useful recommendations on the management of travelers’ diarrhea.

These experts used the following definitions to classify travelers' diarrhea:

  • Mild: diarrhea that is tolerable, not distressing, and does not interfere with planned activities
  • Moderate: diarrhea that is distressing or interferes with planned activities
  • Severe: diarrhea that is incapacitating or completely prevents planned activities; all dysentery (passage of grossly bloody stools) is considered severe
  • Persistent: diarrhea lasting 2 weeks or longer

The CDC suggestions are as follows:

  • Safe food and beverage choices can prevent TD
  • Taking a Bismuth subsalicylate four times per day can prevent TD
  • Treat the symptoms of TD
  • Use antibiotics responsibly
  • Prevent the spread to others.

Travelers can learn more about food and water precautions to prevent bacteria such as Shigella. 

Moreover, when you have travel health questions, it is easy to seek answers from a trusted pharmacist.