Traveller’s Diarrhoea

Refer to NICE Clinical Knowledge Summaries - Diarrhoea - Guidance on prevention + advice for travellers 

 

HIV testing is recommended if unexplained chronic diarrhoea or persistent Cryptosporidiosis diarrhoea >1 month as these are HIV indicator conditions.

 

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'Stand-by' antibiotic should not routinely be offered:

• Most cases of travellers' diarrhoea are mild and self-limiting and will resolve without treatment [Giddings, 2016; Riddle, 2017]

 

• Risks of antibiotic treatment for travellers' diarrhoea include changes to the host microbiome, and the acquisition of multidrug resistant bacteria. In particular, travellers to South and Southeast Asia who take antibiotics for travellers' diarrhoea are at risk for colonization with extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL-PE), which may be harmful to some, for example older people and those prone to urinary tract infections [CDC.2023]

 

• NaTHNaC advises that since travellers who take antibiotics may acquire organisms that are resistant to antibiotics such multi-drug resistant (MDR) Enterobacteriaceae or Clostridium difficile, the prescribing of antibiotics for standby treatment of travellers' diarrhoea should be carefully considered. Groups that may be eligible include people at high risk of developing severe illness, or those visiting high-risk areas in remote locations where access to medical care is limited [NaTHNaC, 2023]