The Medical Letter on Drugs and Therapeutics
Drugs for Travelers' Diarrhea
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The most common cause of travelers’ diarrhea, usually a self-limited illness without fever lasting several days, is infection with noninvasive enterotoxigenic (ETEC) or enteroaggregative (EAEC) strains of Escherichia coli. Campylobacter, Shigella, Salmonella, Aeromonas, viruses and parasites are less common.

TREATMENT — Loperamide – For mild diarrhea, loperamide (Imodium, and others), an over-the-counter synthetic opioid, is FDA-approved for use in adults and children >2 years old. Taken as a 4-mg loading dose, then 2 mg orally after each loose stool to a maximum of 16 (some consultants would stop at 8) mg/d for adults, it can relieve symptoms in <24 hours, and probably should not be used for more than 48 hours. It should not be used if fever or bloody diarrhea is present. Although generally well tolerated, loperamide can cause constipation, sometimes accompanied by distention and ... more      

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