Dupont HL. Systematic review: prevention of travellers’ diarrhoea. Aliment Pharmacol Ther 2008;27:741-51. RATIONALE: Expert opinion is that people travelling to a high-risk area whose condition could be worsened by a bout of diarrhoea may be considered for standby antibiotics.
Centres for Disease Control and Prevention – Travellers’ Health: Yellow Book. http://wwwn.cdc.gov/travel/yellowBookCh4-Diarrhea.aspx Accessed 23.09.14. High-risk countries are defined as most of Asia, the Middle-East, Africa, Mexico, Central and Southern America. Expert opinion is that bismuth subsalicylate (Pepto-Bismol) can be used for prophylaxis: one trial found it reduced the incidence of traveller‟s diarrhoea from 40% to 14%. However, adverse effects are common and, due to its salicylate content, bismuth subsalicylate has several contraindications.
de Bruyn, G., Hahn, S. and Borwick, A. Antibiotic treatment for travellers' diarrhoea. The Cochrane Library. Issue 3. 2000 John Wiley & Sons, Ltd. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002242/abstract Accessed 23.09.14. Of 20 RCTS identified, ten RCTs evaluated short-courses of quinolones, three RCTs evaluated stat doses of quinolones, and one RCT evaluated azithromycin for travellers‟ diarrhoea.
Steffen R, Mathewson JJ, Ericsson CD, Du Pont HL, Helminger A, Balm TK, Wolff K, Witassek F. Traveller’s diarrhoea in West Africa and Mexico: faecal transport systems and bismuth subsalicylate for self-therapy. J Infect Dis 1988;157(5):1008-13. RATIONALE: A two-day treatment course of bismuth reduced the number of stools by 17% compared with placebo.