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Cited by 95Travel-related health issuesSalmonella and Campylobacter epidemiologyAntibiotic Use and Resistance

Antibiotic treatment for travellers' diarrhoea

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de Bruyn, Guy, Hahn, Seokyung, Borwick, Alastair·2000·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd002242PMC PMC6532602
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Abstract

BACKGROUND: Traveller's diarrhoea is a syndrome frequently encountered in persons crossing an international boundary. Diarrhoea can lead to significant discomfort and interference with travel plans. Bacterial pathogens are a frequent cause of this syndrome. Several antibiotics have been tested for efficacy in reducing the duration and severity of the illness. OBJECTIVES: The aims of this review were to assess the effects of antibiotics on traveller's diarrhoea in relation to duration of illness, severity of illness, and adverse effects of medications. SEARCH STRATEGY: The Cochrane Collaboration Trials Register, MEDLINE, and EMBASE were searched. Additional trials were identified by hand searching. Content experts were contacted. SELECTION CRITERIA: All trials in any language in which travellers older than 5 years were randomly allocated to treatment for acute non-bloody diarrhoea with antibiotics and where the causative organism is not known at allocation. DATA COLLECTION AND ANALYSIS: Two reviewers assessed trial quality and extracted data. MAIN RESULTS: Twenty published studies met inclusion and quality criteria for inclusion. Twelve studies were placebo-controlled. A meta-analysis for the primary outcome was not feasible. All of the 10 trials reported a significant reduction in duration of diarrhoea in participants treated with antibiotics compared with placebo. Data from two trials demonstrated a small reduction for antibiotic treated patients in the number of unformed stools passed per each 24 hour period from randomisation up to 72 hours. Data from six trials demonstrated a greater number of participants being cured of diarrhoea by 72 hours (odds ratio [OR] 5. 9, 95% confidence interval [CI] 4.06 to 8.57). Data regarding side effects were available from five trials. There was wide variation in the prevalence of side effects reported in different trials. Persons taking antibiotics experienced more side effects than those taking placebo (OR 2.37, 95% CI 1.5 to 3.75). REVIEWER'S CONCLUSIONS: Antibiotic treatment is associated with shorter duration of diarrhoea but higher incidence of side-effects. Trials generally do not report duration of post-treatment diarrhoea using time-to-event analyses, and should do.

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Crossref · 10.1002/14651858.cd002242

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  • Considering side effects and cost of antibiotics as well as antibiotic resistance, antibiotic treatment does not offer much benefit.

    “Considering the side effects and cost of antibiotics as well as antibiotic resistance, antibiotic treatment does not offer much benefit [58].”

    From Guideline for the Antibiotic Use in Acute Gastroenteritis (2019) · cites this paper as [58]

  • When empirical antibiotic therapy was used for severe traveler's diarrhea, the treatment decreased the duration by 16-30 hours.

    “and by 16 - 30 hours for severe traveler's diarrhea [58]”

    From Guideline for the Antibiotic Use in Acute Gastroenteritis (2019) · cites this paper as [58]

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Authors
de Bruyn, G., Hahn, S., & Borwick, A.
Affiliations
  • Wits Health Consortium; Perinatal HIV Research Unit; PO Box 114 Diepkloof Johannesburg Guateng South Africa 1864
  • Seoul National University (KR)
  • Anne Street Medical Centre; 29 Anne Street Devonport New Zealand
ORCID
Hahn, Seokyung
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2000-07-24
Volume
2019
Issue
5
Pages
CD002242-CD002242
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd002242
PMC
PMC6532602
OpenAlex
W1634081117
Cited by
95
References
45
Citations by year
2025: 2 · 2024: 1 · 2023: 4 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 6 · 2018: 7 · 2017: 9 · 2016: 5 · 2015: 4 · 2014: 3 · 2013: 2 · 2012: 2
FWCI
0.21
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Travel-related health issues
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
Keywords
traveler's diarrhea, antibiotic therapy, diarrhea duration, diarrhea severity, adverse drug reactions, bacterial diarrhea, antibiotic adverse effects
MeSH terms
Acute Disease, Administration, Oral, Adult, Anti-Bacterial Agents, Child, Diarrhea, Humans, Travel

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