bismuth-subsalicylate and Dysentery

Travelers' diarrhea is the most common travel-related malady. It affects millions of international travelers to developing countries annually and can significantly disrupt travel plans.. To provide an update on the evaluation, diagnosis, treatment, and prevention of traveler's diarrhea.. A PubMed search was completed in Clinical Queries using the key term "traveler's diarrhea". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature. Patents were searched using the key term "traveler's diarrhea" from www.freepatentsonline.com.. Between 10% and 40% of travelers develop diarrhea. The attack rate is highest for travelers from a developed country who visit a developing country. Children are at particular risk. Travelers' diarrhea is usually acquired through ingestion of food and water contaminated by feces. Most cases are due to a bacterial pathogen, commonly, Escherichia coli, and occur within the first few days after arrival in a foreign country. Dehydration is the most common complication. Pretravel education on hygiene and on the safe selection of food items is important in minimizing episodes. For mild travelers' diarrhea, the use of antibiotic is not recommended. The use of bismuth subsalicylate or loperamide may be considered. For moderate travelers' diarrhea, antibiotics such as fluoroquinolones, azithromycin, and rifaximin may be used. Loperamide may be considered as monotherapy or adjunctive therapy. For severe travelers' diarrhea, antibiotics such as azithromycin, fluoroquinolones, and rifaximin should be used. Azithromycin can be used even for the treatment of dysentery whereas fluoroquinolones and rifaximin cannot be used for such purpose. Recent patents related to the management of travelers' diarrhea are discussed.. Although travelers' diarrhea is usually self-limited, many travelers prefer expedient relief of diarrhea, especially when they are traveling for extended periods by air or ground. Judicious use of an antimotility agent and antimicrobial therapy reduces the duration and severity of diarrhea.

Topics: Anti-Bacterial Agents; Azithromycin; Bismuth; Dehydration; Developing Countries; Dysentery; Escherichia coli; Escherichia coli Infections; Fluoroquinolones; Food Contamination; Health Knowledge, Attitudes, Practice; Humans; Loperamide; Organometallic Compounds; Patient Education as Topic; Salicylates

Along with the dizzying rise in the world's population and economic globalization, travel activity has also increased. Travelers' diarrhea, caused by changed sanitary conditions, has a very different pathogenic spectrum and clinical course from those of our native forms of infectious enterocolitis. Awareness of the warning signs of complications in the clinical course and of the differential diagnoses is therefore a prerequisite for rational therapy. This covers oral rehydration, motility inhibitors, adsorbents, antisecretory agents, probiotics, and last but not least the use of antibiotics, which make an essential contribution if correctly used. There are interesting developments in the form of nonabsorbable antibiotics and new antisecretory agents, which inhibit protein synthesis and enzymes and are increasingly used as antidiarrheal agents with few side effects. In the combination of various therapeutic options in travelers' diarrhea there is still much scope for research. The priority is the correct implementation of the options available today, in order to avoid, as far as possible, therapeutic setbacks and the development of resistance.

Topics: Adult; Anti-Bacterial Agents; Atropine; Bismuth; Child; Cross-Sectional Studies; Diphenoxylate; Drug Combinations; Dysentery; Fluid Therapy; Fluoroquinolones; Humans; Loperamide; Organometallic Compounds; Probiotics; Risk Factors; Salicylates; Travel

Topics: Anti-Bacterial Agents; Antidiarrheals; Antiprotozoal Agents; Bismuth; Campylobacter Infections; Dysentery; Enteropathogenic Escherichia coli; Escherichia coli; Escherichia coli Infections; Giardiasis; Humans; Loperamide; Multiplex Polymerase Chain Reaction; Organometallic Compounds; Salicylates; Shiga-Toxigenic Escherichia coli; Travel-Related Illness

Topics: Adult; Anti-Bacterial Agents; Antidiarrheals; Atropine; Bismuth; Child; Cross-Sectional Studies; Diarrhea; Diphenoxylate; Drug Combinations; Dysentery; Fluid Therapy; Fluoroquinolones; Humans; Loperamide; Organometallic Compounds; Probiotics; Risk Factors; Salicylates; Travel