Antibiotics for travellers' diarrhoea

The cause may be bacterial, viral, or parasitic, and the right treatment varies. An unsuitable antibiotic may cause side effects, interact with other medicines, or make later diagnosis harder without treating the responsible organism.

Food or water contaminated with infectious organisms can cause loose stools, cramps, nausea, vomiting, or fever during or after travel. The destination, timing, duration, stool appearance, food and water exposures, and illnesses among companions help a clinician narrow the possibilities.

Blood in the stool, high fever, severe abdominal pain, prolonged symptoms, or reduced immunity change the assessment. Stool testing may be considered when illness is severe, persistent, recurrent, or linked to particular exposures. Some parasites need specific medicines rather than the antibiotics used for bacterial diarrhoea.

Take frequent small sips of oral rehydration solution prepared exactly as directed with safe water. Continue tolerable foods, choosing simple meals if appetite is low. Breastfeeding should continue. Careful handwashing after toilet use and before handling food reduces spread to companions.

Do not take leftover or borrowed antibiotics. Before using an anti-diarrhoeal medicine, ask a pharmacist or clinician whether it suits your age and symptoms; such medicines may be inappropriate when there is blood in the stool, fever, or suspected invasive infection. If an antibiotic was supplied for emergency travel use, follow its written plan and seek care when the plan advises.

Seek urgent care for confusion, fainting, severe weakness, inability to keep fluids down, very little urine, marked dizziness on standing, blood or black stool, severe or localised abdominal pain, or a rigid or swollen abdomen. A baby, older adult, pregnant person, or someone with reduced immunity can become unwell more quickly and should receive earlier advice.

Arrange a medical review if diarrhoea persists after travel, repeatedly returns, is accompanied by fever, or follows recent antibiotic use or a hospital stay. Tell the clinician every country visited, travel dates, water and food exposures, animal contact, and medicines already taken.

Ask whether your symptoms suggest testing, what oral rehydration product to use, and which findings would justify an antibiotic. Discuss allergies, pregnancy, heart rhythm problems, kidney or liver disease, medicines that interact, and any previous infection with antibiotic-resistant bacteria before a prescription is chosen.