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[Consensus paper treatment of acute traveler's diarrhea. Practice recommendation for travel advice].
MMW Fortschr Med. 2017 03; 159(Suppl 4):4-11.MF

Abstract

BACKGROUND

In times of mass tourism, traveler's diarrhea is one of the most common health problems of long-distance travel. Globally, some 40 million cases occur annually. Travellers to risk areas should therefore be comprehensively advised beforehand, as to what action to take in case of an acute traveler's diarrhea and what drugs to add to their first-aid kit. To date none, or hardly any specific studies or valid specific guidelines for the treatment of traveler's diarrhea are available for Germany.

METHOD

Drafting a consensus paper based on results of a specialists' meeting to evaluate therapeutic options in the treatment of acute uncomplicated travelers' diarrhea. The foundation for the present consensus recommendations is current evidence on antidiarrheals available in Germany for symptomatic treatment of gastrointestinal infections, summarized in the S2k guideline for gastrointestinal infections and Whipple's disease. Further taken into account for the present consensus recommendations were Pubmed-listed publications on symptomatic treatment of traveler's diarrhea, practical aspects, and the experts' experience in travel medicine.

RESULTS AND CONCLUSION

For the treatment of acute uncomplicated traveler's diarrhea - more than 90 % of all cases - the secretion inhibitor racecadotril is considered first choice, based on our evaluation criteria. The previously usual practice of recommending the antimotility drug loperamide as first choice should be reconsidered, in favor of the recent active ingredient racecadotril. Antibiotics should be used only in complicated cases. A large number of travelers who generally demand antibiotic therapy should be disabused of their expectations. Other therapeutic measures that are currently available for the treatment of acute diarrhea while traveling play a subordinate role.

Authors+Show Affiliations

BCRT - Berliner Centrum für Reise- und Tropenmedizin, Friedrichstr. 134, D-10117, Berlin, Deutschland. jelinek@bcrt.de. Institut für Medizinische Mikrobiologie, Immunologie und Hygiene, Klinikum der Universität zu Köln, Köln, Deutschland. jelinek@bcrt.de.Abteilung für Infektions- und Tropenmedizin, Klinikum der Universität München, München, Deutschland.Labor Hannover MVZ GmbH, Hannover, Deutschland.Klinikum Ernst von Bergmann, Potsdam, Deutschland.

Pub Type(s)

Journal Article

Language

ger

PubMed ID

28244025

Citation

Jelinek, Tomas, et al. "[Consensus Paper Treatment of Acute Traveler's Diarrhea. Practice Recommendation for Travel Advice]." MMW Fortschritte Der Medizin, vol. 159, no. Suppl 4, 2017, pp. 4-11.
Jelinek T, Nothdurft HD, Haditsch M, et al. [Consensus paper treatment of acute traveler's diarrhea. Practice recommendation for travel advice]. MMW Fortschr Med. 2017;159(Suppl 4):4-11.
Jelinek, T., Nothdurft, H. D., Haditsch, M., & Weinke, T. (2017). [Consensus paper treatment of acute traveler's diarrhea. Practice recommendation for travel advice]. MMW Fortschritte Der Medizin, 159(Suppl 4), 4-11. https://doi.org/10.1007/s15006-017-9293-2
Jelinek T, et al. [Consensus Paper Treatment of Acute Traveler's Diarrhea. Practice Recommendation for Travel Advice]. MMW Fortschr Med. 2017;159(Suppl 4):4-11. PubMed PMID: 28244025.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Consensus paper treatment of acute traveler's diarrhea. Practice recommendation for travel advice]. AU - Jelinek,Tomas, AU - Nothdurft,Hans-Dieter, AU - Haditsch,Martin, AU - Weinke,Thomas, Y1 - 2017/02/27/ PY - 2016/10/16/received PY - 2016/12/01/accepted PY - 2017/3/1/entrez PY - 2017/3/1/pubmed PY - 2018/7/13/medline KW - consensus recommendation KW - loperamide KW - racecadotril KW - traveler’s diarrhea SP - 4 EP - 11 JF - MMW Fortschritte der Medizin JO - MMW Fortschr Med VL - 159 IS - Suppl 4 N2 - BACKGROUND: In times of mass tourism, traveler's diarrhea is one of the most common health problems of long-distance travel. Globally, some 40 million cases occur annually. Travellers to risk areas should therefore be comprehensively advised beforehand, as to what action to take in case of an acute traveler's diarrhea and what drugs to add to their first-aid kit. To date none, or hardly any specific studies or valid specific guidelines for the treatment of traveler's diarrhea are available for Germany. METHOD: Drafting a consensus paper based on results of a specialists' meeting to evaluate therapeutic options in the treatment of acute uncomplicated travelers' diarrhea. The foundation for the present consensus recommendations is current evidence on antidiarrheals available in Germany for symptomatic treatment of gastrointestinal infections, summarized in the S2k guideline for gastrointestinal infections and Whipple's disease. Further taken into account for the present consensus recommendations were Pubmed-listed publications on symptomatic treatment of traveler's diarrhea, practical aspects, and the experts' experience in travel medicine. RESULTS AND CONCLUSION: For the treatment of acute uncomplicated traveler's diarrhea - more than 90 % of all cases - the secretion inhibitor racecadotril is considered first choice, based on our evaluation criteria. The previously usual practice of recommending the antimotility drug loperamide as first choice should be reconsidered, in favor of the recent active ingredient racecadotril. Antibiotics should be used only in complicated cases. A large number of travelers who generally demand antibiotic therapy should be disabused of their expectations. Other therapeutic measures that are currently available for the treatment of acute diarrhea while traveling play a subordinate role. SN - 1438-3276 UR - https://www.unboundmedicine.com/medline/citation/28244025/[Consensus_paper_treatment_of_acute_traveler's_diarrhea__Practice_recommendation_for_travel_advice]_ L2 - https://dx.doi.org/10.1007/s15006-017-9293-2 DB - PRIME DP - Unbound Medicine ER -