california
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Topics: 56
Posts: 77
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A 43 year old businesswoman is developing a new enterprise in Mexico. On her most recent trip, she developed diffuse watery diarrhea with severe cramps
1. the most likely causative organism is
a. campylobacter
b. E. coli
c. salmonella
d. shigella
e. rotavirus
2. She has no fever and no blood in her stools. Appropriate treatment would include
a. amoxicillin
b. symptomatic therapy with loperamide
c. doxycycline
d. oral rehydration only
e. specific antitoxin
3. To prevent future episodes during business trips, as well as being more careful in eating. She should take prophylactic
a. loperamide
b. trimethroprim-sulfamethoxazole
c. ciprofloxacin
d. doxycycline
e. bismuth subsalicylate
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| phuluong2k
Forum Fanatic
Topics: 714
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1 B
2D
3B
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| kmp
Forum Elite
Topics: 38
Posts: 311
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Traveler's Diarrhea
1) b. E. coli
2) b. symptomatic therapy with loperamide (for mild to moderate cases)
3) e. bismuth subsalicylate (resistance to trimethroprim-sulfamethoxazole on routine use)
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| mesh
Forum Guru
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B
D
B
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| PKG
Forum Senior
Topics: 25
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cmtd says that routine prophylaxix is ot required in travellers diarrhoea, unless the patient is immunocompromised(hiv), has ibd or on immunosuppresive medications.......california, can you tell me what drug is used for prophylaxis in such patients?
please reply
thanks in advace
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| Dot
Forum Senior
Topics: 1
Posts: 168
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1. B
2.D
3.C ( Kaplan says that for travellers diarrhoea either ciproflox or azithro should be given
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| chemamr
Forum Hero
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b,d,c
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| california
Forum Senior
Topics: 56
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answer
1. b
2. b
3. e
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| california
Forum Senior
Topics: 56
Posts: 77
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answer
1. b
2. b
3. e
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| ruhighazi
Forum Senior
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Posts: 76
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Prophylactic antibiotics are effective in preventing the majority of diarrheal disease in travelers, but cannot be recommended unless the complications of diarrhea or an underlying medical condition make the consequence of dehydration so severe that the benefits of using antibiotic prophylaxis outweigh the risks.
Some situations in which it might be reasonable to consider prophylactic antibiotics include: known severe inflammatory bowel disease which could be exacerbated by an episode of infectious diarrhea; severe vascular, cardiac, or renal disease which would be seriously compromised by dehydration; or severe immunocompromise such as advanced HIV disease, or after a complicated organ transplant such as a liver or cardiac transplant. Studies with prophylactic antibiotics were predominantly performed with older agents such as TMP-SMX or doxycycline. However, these drugs are generally not used since susceptibility among the bacteria causing TD have changed.
Most travelers requiring prophylaxis are given a quinolone antibiotic at the same doses used for treatment.
Nonantibiotic preventive methods have also been studied. Bismuth subsalicylate (30 mL or two tablets four times daily with meals) can prevent a significant number of cases of TD. However, the doses required make this inconvenient for the traveler, and the same cautions about salicylate toxicity apply when used for prevention as well as therapy.
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