Antibiotic self-treatment of travelers' diarrhea: It only gets worse

Even the use of loperamide has been shown to increase the risk of drug resistant gut enteric bacteria when added to antibiotic treatment of TD whereas loperamide use alone did not increase this risk [4] In fact, loperamide appears to be no less effective than an antibiotic in the management of mild to moderate travelers' diarrhea [5] Although the vast majority of those returning from international travel with ESBL-PE remain asymptomatic, a recent study has shown that 50% will carry the bacteria for 1 month but 10% for up to a year. The additional bad news in this scenario is the fact that bacterial co-resistance was transferred to other antibiotics such a tobramycin, a non-beta lactam antibiotic, that shares genetic resistance genes with ciprofloxacin. References 1 J. Josseaume, L. Verner, W.J. Brady, F.X. Duchateau, Multidrug-resistant bacteria among patients treated in foreign hospitals: management considerations during medical repatriation, J Travel Med,...