Clinical presentation and management of travelers’ diarrhea

For more than three decades, clinical trials have repeatedly demonstrated that antibiotic therapy significantly shortens the duration of illness and reduces the disability associated with arguably the most common travel-associated illness. Left untreated, the average travelers’ diarrhea episode lasts can last 3 days or more, and not infrequently result in a change in itinerary or inability to fulfill travel objectives. Treatment with an effective antibiotic can reduce the duration to a little longer than a day, and in combination with an antimotility agent such as loperamide, the duration is shortened to half a day. However, most recently the concern of acquisition of multidrug-resistant organisms due to travel, experiencing travelers’ diarrhea, and its therapy, has led to important consideration about both individual and population health impacts. Though further research is needed, judicious use of antibiotics in treatment is warranted and will require well-considered and clear counseling with travelers on what to do when they become ill.