Abstract
Traveler’s diarrhea (TD) is an acute, self-limited disease, caused by a wide array of germs that possess intestinal tropism. Among the 12 million people travelling annually to tropical or subtropical areas, 30% up to 70% are affected by TD. A single episode of diarrhea can severely impair, sometimes severe, the performance of special categories of travelers, like sportsmen, business people, or diplomats in specific missions. The disease has an equal distribution among sexes, occurring with a higher frequency among the youth. The Enterotoxigenic E.coli is the main pathogen incriminated in 80 to 90% of TD’cases. Recent international infectious disease or traveler medicine guidelines are recommending Rifaximine-α(RFX) as the first therapeutical option with the highest level of recommendation and evidence (IA) in treating or preventing non-invasive forms of TD. The normal daily dosage in these cases is 800 mg of RFX for at least 3 days. RFX is a non-absorbable (intestinal) antibiotic which has clinically proven its high rate of success regarding its safety and efficacy in treating and preventing TD. Referring to TD’s prevention, it must be mentioned that even though antibiotic prophylaxis is not routinely recommended while travelling (at least in cases of more than 3 weeks of travel), this approach should be serious taken into consideration for several types of high risk traveler patients who present at least one of the following conditions: immunodeficiency, chronic inflammatory intestinal diseases, kidney failure or diabetes mellitus. But even there are or not real reasons in recommending antibiotic prophylaxis, Rifaximine-α should not miss from any personal first-aid traveler-kit.
Highlights
Traveler’s diarrhea (TD) is an acute, self-limited disease, caused by a wide array of germs that possess intestinal tropism
Etiologia bacteriană este răspunzătoare de 80-90% din cazurile de Diareea călătorului (DC) [2]
Infecţiile cauzate de protozoare patogene (Giardia, Entamoeba histolytica, Cryptosporidium, Dientamoeba fragilis) sunt caracterizate de un debut mai lent al simptomelor, această etiologie reprezentând aproximativ 10% din totalul diareilor apărute în contextul călătoriilor de lungă durată
Summary
Ea afectează 30-70% din cele 12 milioane de călători care se deplasează anual în zone tropicale sau subtropicale. Diareea călătorului prezintă distribuţie egală pe sexe, fiind totuşi mai frecventă în rândul tinerilor. Ghidurile internaţionale recente de boli infecţioase şi de medicina călătoriei recomandă Rifaximina-α (RFX), cu nivel de indicaţie IA, drept principală opţiune terapeutică pentru antibioticoterapia formelor noninvazive de DC atât în scop profilactic, cât şi curativ, doza recomandată fiind de 800 mg /zi timp de minimum 3 zile. Referitor la prevenţie trebuie precizat că antibioticoprofilaxia DC, deşi nu este recomandată de rutină, mai ales în cazul călătoriilor care depăşesc 3 săptămâni, poate fi luată serios în discuţie pentru unele categorii de pacienţi-călători la risc, cum sunt cei cu imunodepresie, boli intestinale inflamatorii cronice, insuficienţă renală cronică sau diabet zaharat.
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