Traveller's Diarrhoea (Anticipatory Management)

Comments from Expert Advisory Group

• Antibiotic treatment is only indicated for those patients who are at high risk of severe adverse outcomes if they contract  travellers’ diarrhoea
• Discuss the likelihood of travellers’ diarrhoea with someone who is planning to travel and advise about avoidance measures to decrease the risk of illness: safe foods, beverages, and eating establishments
• Consider referring travellers who have special health needs (for example, HIV infection, immunocompromised, pregnant) to a specialist travel clinic for advice
• Limit prescription of antibiotics to be carried abroad and taken if illness develops (stand-by) to people for whom an episode of travellers' diarrhoea could be dangerous. See table below for further information regarding “stand-by” antibiotics for this at risk group.
• AVOID the routine use of prophylactic antibiotics - seek specialist advice before prescribing.
• Useful links for additional information;
  • Centre for Disease Control and Prevention: Travellers' Diarrhea
  • TravelHealthPro - travellers’ diarrhoea

Treatment

Safe Prescribing (visit the safe prescribing page)

• Doses are oral and for adults unless otherwise stated
• Clarithromycin and other macrolides warning
• Renal impairment dosing table
• Safety in Pregnancy and Lactation
• Drug interactions table. Extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants.
• Visit the Health Products Regulatory Authority (HPRA) website for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC).

Reviewed July 2023