From the Guidelines
Augmentin is not the preferred treatment for traveler's diarrhea, and azithromycin is recommended as the first-line agent due to its efficacy and safety profile. The decision to treat traveler's diarrhea with antibiotics is based on the severity of illness and its impact on the traveler's activities 1. Antibiotics have been shown to reduce symptom duration in traveler's diarrhea, and azithromycin has demonstrated equivalent efficacy to fluoroquinolones (FQs) in treating watery noninvasive diarrhea 1.
Key considerations in selecting an empiric antibiotic include the likelihood of treatment efficacy, regional patterns of probable target pathogens and their antimicrobial resistance, safety and tolerance profile, and cost 1. Azithromycin should be considered the first-line agent in cases of dysentery and acute watery diarrhea with greater than mild fever due to its effectiveness against FQ-resistant Campylobacter and other bacterial causes 1.
The use of Augmentin (amoxicillin-clavulanate) is not typically recommended as a first-line treatment for traveler's diarrhea due to its lower efficacy against common bacterial causes such as enterotoxigenic E. coli, Campylobacter, and Shigella species 1. In contrast, azithromycin has been shown to be superior to levofloxacin in achieving clinical cure in settings with high rates of FQ-resistant Campylobacter 1.
Some important points to consider when treating traveler's diarrhea include:
- Oral rehydration solutions and loperamide can be used for symptom relief 1
- Antibiotics should only be used for moderate to severe cases with fever or bloody diarrhea 1
- Consulting a healthcare provider before travel is recommended to get appropriate medications based on destination and medical history 1
- Safe food and water practices should be prioritized for prevention rather than prophylactic antibiotics 1
From the Research
Treatment Options for Travelers' Diarrhea
- Travelers' diarrhea is usually acquired through ingestion of food and water contaminated by feces, with most cases due to a bacterial pathogen, commonly Escherichia coli 2.
- For mild travelers' diarrhea, the use of antibiotics is not recommended, while for moderate cases, antibiotics such as fluoroquinolones, azithromycin, and rifaximin may be used 2.
- Augmentin, a combination of amoxicillin and clavulanic acid, is not specifically mentioned as a treatment option for travelers' diarrhea in the provided studies.
Role of Antibiotics and Antimotility Agents
- The use of antibiotic therapy, compared with placebo, has been established as effective for treatment of traveler's diarrhea 3.
- Adjunctive loperamide in combination with antibiotics has been shown to offer an advantage over antibiotics alone by decreasing the illness duration and increasing the probability of early clinical cure 3.
- However, there is no direct evidence in the provided studies to support the use of Augmentin for travelers' diarrhea.
Fluid and Dietary Management
- Travelers' diarrhea is associated with a mild or moderately severe loss of fluid and electrolytes, and treatment of fluid and electrolyte deficits may be effectively achieved by rehydration with oral rehydration solution or a commercial solution of similar composition 4.
- Dietary recommendations should emphasize the necessity of resuming a normal diet once a reduction in symptoms makes this feasible, with eating small portions frequently and omitting caffeine and lactose-containing food and drink may be advantageous 4.