What gastrointestinal (G.I.) infections should I be concerned about when traveling to Western Samoa, and what antibiotic should I take if I develop diarrhea or other gastrointestinal symptoms?

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Last updated: May 6, 2025View editorial policy

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From the Guidelines

When traveling to Western Samoa, you should be concerned about gastrointestinal infections like traveler's diarrhea, and azithromycin (500mg once daily for 1-3 days) is the recommended antibiotic for self-treatment of diarrhea due to its effectiveness against most bacterial causes of traveler's diarrhea in the region 1. The primary concern for gastrointestinal infections in Western Samoa is traveler's diarrhea, which can be caused by various bacterial pathogens.

  • The symptoms of traveler's diarrhea can range from mild to severe and may include diarrhea, abdominal cramps, fever, and bloody stools.
  • According to the guidelines for the prevention and treatment of travelers' diarrhea, azithromycin is the recommended first-line agent for the treatment of dysentery and acute watery diarrhea with greater than mild fever 1.
  • The medication is effective against a wide range of bacterial causes of traveler's diarrhea, including Campylobacter, Shigella, and Salmonella species.
  • Azithromycin has been shown to be superior to levofloxacin in achieving clinical cure in areas with high rates of fluoroquinolone-resistant Campylobacter species 1.
  • In addition to azithromycin, it is also recommended to bring loperamide (Imodium) for symptom relief, and to stay hydrated with oral rehydration solutions if diarrhea develops.
  • Preventive measures are crucial, including drinking only bottled or purified water, avoiding raw vegetables, unpeeled fruits, and street food, and practicing good hand hygiene.
  • Consider getting vaccinated for hepatitis A and typhoid before your trip to Western Samoa.
  • It is essential to seek medical attention if you experience high fever, bloody diarrhea, severe abdominal pain, or if symptoms persist beyond 3-4 days despite treatment.

From the FDA Drug Label

Infectious Diarrhea caused by Escherichia coli (enterotoxigenic strains), Campylobacter jejuni, Shigella boydii†, Shigella dysenteriae, Shigella flexneri or Shigella sonnei† when antibacterial therapy is indicated.

When traveling to Western Samoa, you should be worried about infectious diarrhea caused by bacteria such as Escherichia coli, Campylobacter jejuni, and Shigella species. If you develop diarrhea or other G.I. related symptoms, ciprofloxacin may be considered as a treatment option, but only when antibacterial therapy is indicated 2.

Key considerations:

  • Always consult a healthcare professional before taking any medication.
  • Appropriate culture and susceptibility tests should be performed before treatment to determine the causative organism and its susceptibility to ciprofloxacin.
  • Ciprofloxacin should only be used to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.

From the Research

G.I. Related Infections in Western Samoa

When traveling to Western Samoa, it is essential to be aware of the potential G.I. related infections that can occur. Some of the common infections include:

  • Salmonellosis
  • Shigellosis
  • Campylobacter infections
  • Infections with pathogenic Escherichia coli strains
  • Yersiniosis
  • Cholera

Antibiotic Treatment

In case of diarrhea or other G.I. related symptoms, antibiotic treatment may be necessary. However, it is crucial to note that:

  • Empirical antibiotic therapy should only be considered for severely ill patients with a high frequency of stools, fever, bloody diarrhea, underlying immune deficiency, advanced age, or significant comorbidities 3
  • Increasing resistance, particularly against fluoroquinolones, must be taken into consideration 3
  • Azithromycin may be an effective treatment for fully sensitive strains of S. Typhi, but it is associated with delayed treatment response and prolonged bacteraemia when compared with ciprofloxacin 4

Recommended Antibiotics

Based on the available evidence, the following antibiotics may be considered:

  • Azithromycin (500mg daily) for the treatment of uncomplicated enteric fever 4
  • Ciprofloxacin (500mg twice-daily) for the treatment of uncomplicated enteric fever, although resistance should be considered 4, 3
  • Fidaxomicin for the treatment of Clostridium difficile infections (CDI) 3

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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