TREATMENT FOR TRAVELERS' DIARRHEA
The following recommendations for treating travelers' diarrhea are excerpted from a section summary of the consensus conference report released on Jan. 30. Travelers' diarrhea is usually a mild, self-limited disorder, with complete recovery even in the absence of therapy; hence, therapy should be considered optional. 1. Fluids should be taken . . . 2. If rapid relief of symptoms is desired after 1 or 2 unformed stools accompanied by cramps, nausea, or malaise, diphenoxylate or loperamide may be taken. An alternative is to start bismuth subsalicylate (1 oz every 30 minutes for eight doses). Although this regimen decreases the number of stools and increases their consistency, it does not improve symptoms during the first 4 hours of treatment. 3. If it is important to shorten the course or decrease the severity of moderate to severe travelers' diarrhea, antimicrobial agents may be taken. After 3 or more loose stools with symptoms, considerations can be given to a short course of triamethoprim/sulfamethoxazole or trimethoprim alone or doxycycline. 4. A small percentage of travelers have persisting diarrhea with serious fluid loss, fever, and blood or mucus in the stolls. This suggests that a more serious illness is involved, and such individuals should seek medical attention.
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