Antibiotics and Treatment for Traveler's Diarrhea

• Local water and food that is undercooked are often the cause of traveler's diarrhea.
  
  
• In general, drink and eat only packaged liquids, food that is steaming hot, or fruit that you have peeled yourself. Do not use ice in areas where water can be contaminated, and avoid salads and other fresh foods. Do not eat foods from roadside vendors or brush your teeth using tap water. Despite precautions, illness rates can be up to 50%.
  
  
• Two Pepto-Bismol tablets taken 4 times per day can decrease the incidence of traveler’s diarrhea by about 60%. Pepto-Bismol turns a person’s tongue or stools black. People who are sensitive to aspirin, people taking certain drugs (ie, blood thinners, methotrexate, probenecid), and those with kidney problems should avoid Pepto-Bismol. It should not be given to children younger than 3 years.
  
  
• One or 2 Imodium tablets every 4 hours as needed can reduce the frequency of stools, but people with fever or bloody stools should use this agent carefully (if at all).
  
  
• Certain antibiotics (such as trimethoprim-sulfamethoxazole or ciprofloxacin) can reduce the duration of symptoms in cases of bacterial infection; however, these agents should not be used to prevent infection. In order to control the resistance of bacteria to currently effective antibiotics used to treat traveler’s diarrhea when it does occur, the US Centers for Disease Control and Prevention advises against the use of antibiotics to prevent traveler’s diarrhea.
  
  
• Oral rehydration therapy (ORT): The World Health Organization recommends the following salt solution mixture: 3.5 grams of salt (ie, sodium chloride), 1.5 grams of potassium chloride, 20 grams of glucose, and 2.9 grams trisodium citrate (alternatively, 2.5 grams sodium bicarbonate). These ingredients should be mixed in 1 liter of clean water. This will improve rehydration by providing both salts and glucose, which increase transport of both substances across the intestinal wall. Premixed commercial ORT preparations (such as Pedialyte) are available for children.