Montezuma's revenge. The traveler's two step. Call it what you want, but traveler's diarrhea is unpleasant and can make a tourist see only the sites available in foreign bathrooms. Many travelers take some broad-spectrum antibiotics with them, just in case they catch it. But research is showing that taking antibiotics for mild or moderate diarrhea while travelling can bring back drug-resistant bacteria when they come home.
Antibiotics increase a traveler's risk of being colonized with a resistant strain of bacteria called beta-lactamase-producing Enterobacteriaceae (ESBL-PE), according to a study conducted in Finland. The researchers obtained stool samples from 430 Finns before and after they made trips outside of Scandinavia. Ninety of them, about one in five, became colonized with EBL-PE.
Not all of these traveler's had had diarrhea, but two of the risk factors for coming back with the resistant bug were having diarrhea and taking antibiotics to treat it. One-third of the people who took antibiotics to treat diarrhea during their travel came back with ESBL-PE. Eighty percent of those who traveled to South Asia and took antibiotics to treat diarrhea came back carrying ESBL-PE. Other problem areas for picking up the resistant strain were Southeast Asia, East Asia, North Africa, and the Middle East.
The people who came home with the resistant bacteria did not show any noticeable symptoms.
The researchers stated that it might be best to avoid treating anything but serious cases of travelers' diarrhea. They noted that 300 million people each year visit areas of the world where there is poor hygiene and a good chance of coming down with diarrhea. If 20% of these travelers are coming back carrying a resistant strain of bacteria, that is a substantial number of people who could unknowingly be spreading it in their communities.
Most cases of travelers' diarrhea go away on their own and do not need to be treated with antibiotics. The problem should be treated by drinking plenty of fluids and taking over-the-counter antidiarrhea medicines. A traveler should seek medical attention only if other symptoms occur, such as a high fever, bloody stools, or serious dehydration.