• Attend to hydration.
• Patient can self-administer antibiotic—e.g. norfloxacin 400 mg bd for 3 days, or ciprofloxacin; use co-trimoxazole in children.
• Avoid Lomotil or Imodium.
• Attend to hydration—use an oral hydrate solution, e.g. Gastrolyte or WHO formulation.
• Avoid Lomotil and Imodium.
• Antibiotic: norfloxacin or ciprofloxacin.
Note: There is increasing resistance to doxycycline and co-trimoxazole, especially in South-East Asia. Persistent diarrhoea
Any travellers with persistent diarrhoea after visiting less developed countries, especially India and China, may have a protozoal infection such as amoebiasis or giardiasis. If the patient has a fever and mucus or blood in the stools, suspect amoebiasis. Giardiasis is characterised by abdominal cramps, flatulence, and bubbly, foulsmelling diarrhoea persisting beyond 2 to 4 days. Treatment
Giardiasis: tinidazole or metronidazole Amoebiasis: metronidazole or tinidazole
Patient can self-administer these drugs and carry them if visiting areas at risk, but they can have a severe adverse reaction with alcohol.
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