Traveller’s Diarrhoea is a very common condition that effects 20-50% of international travellers. It is usually
experienced during the first two weeks of travelling to a foreign destination and is more common in the developing
world where it can effect 60% of travellers.
Traveller’s Diarrhoea is defined as passing three or more loose,
unformed stools within a 24 hour period often accompanied by nausea, bloating, stomach pain, vomiting and/or fever.
What Causes Traveller’s Diarrhoea
Traveller’s Diarrhoea is usually caused by exposure to bacteria, which the body is not used to. Bacterial infections
normally account for around 85% of cases. For the local population often these bacteria are completely harmless but
for foreign traveller’s this may lead to infection. Viruses and parasites may also account for a small minority of
cases (less than 15%) but are far less common than bacterial causes.
Organisms causing traveller’s diarrhoea
include bacteria such as E. coli and Salmonella, parasites such as Giardia and viruses like the norovirus. These
organisms can be spread by eating contaminated food, drinking contaminated drinks as well as contact with dirty
hands and plates.
How to Prevent Traveller’s Diarrhoea
Avoiding contaminated foods is one of the most important ways to avoid Traveller’s Diarrhoea. Basic precautions
should be taken including:
Drink only safe water and beverages (boiled, bottled, distilled). Avoiding drinking tap water or hot
drinks, which have not been boiled.
Avoid having ice cubes with your drinks as they may contain contaminated tap water
Avoid eating ice-cream or other frozen desserts as many developing countries experience frequent power
cuts which means frozen products often defrost and refreeze
Avoid eating raw fruit and vegetables that you have not peeled yourself
Avoid eating salads as they may have been washed with contaminated water
Ensure you wash your hands before eating
Anti-Biotic Standby Treatment
If you are travelling abroad you may wish to carry with you antibiotic treatment in case you experience symptoms of
traveller’s diarrhoea. Antibiotics are only effective against bacterial infections, which are the most common cause
of traveller’s diarrhoea (85% of cases). Anti-biotics will not be effective at treating diarrhoea from parasites or
Standby treatment is recommended for certain travellers including:
Travellers who frequently experience diarrhoea when travelling abroad
Travellers with existing bowel conditions such as IBS
Travellers to remote destinations where medical help is not easily available
Travellers with existing medical conditions, which may be made worse by severe diarrhoea/dehydration
Choosing Ciprofloxacin vs Azithromycin
For most destinations ciprofloxacin is the recommended anti-biotic for treating traveller’s diarrhoea. However, if you
are travelling to South or South East Asia azithromycin is recommended due to resistance to quinolone in those
How To Take
Take one 500mg tablet daily for 3 days.
Take one 500mg tablet twice daily for 1 day. If no improvement, treatment can be extended for up to 3 days.
Like all medicines, ciprofloxacin and azithromycin can cause side effects, although not everybody gets them.
Common side effects include nausea, diarrhoea, stomach pain and flatulence.
Check the patient information
leaflet for more information.
Patient Information Leaflet
Always read the patient information leaflet before commencing treatment.
Patient information can be found here.