Ericsson C D
Department of Medicine, University of Texas Houston Medical School, Houston, USA.
Infect Dis Clin North Am. 1998 Jun;12(2):285-303. doi: 10.1016/s0891-5520(05)70006-4.
Risk factors for travelers' diarrhea include adventurous behavior, consumption of unclean water or food, and special hosts like those taking long acting H2 blockers. Approaches to prevention include education about risk factors, which often fails to lead to modification of risky behavior, and chemoprophylaxis with bismuth subsalicylate-containing compounds or antimicrobial agents. Chemoprophylaxis is generally discouraged except in special circumstances and in high-risk hosts. Self-treatment of travelers' diarrhea is successful in limiting the course of diarrhea and minimizing losses of vacation and business time. Current therapeutic options, in order of increasing effectiveness, include attapulgite, BSS-containing compounds, loperamide, antimicrobial agents such as the fluoroquinolones, and the combination of loperamide and an antimicrobial agent. Under study are a nonabsorbed antimicrobial agent, rifaximin, and a novel calmodulin inhibitor, zaldaride. Development and evaluation of vaccines against enterotoxigenic Escherichia coli and Shigella are proceeding apace but are not yet available for routine use.
旅行者腹泻的危险因素包括冒险行为、饮用不洁水或食用不洁食物，以及服用长效H2阻滞剂等特殊宿主。预防方法包括对危险因素进行教育（但这往往无法改变危险行为），以及使用含碱式水杨酸铋的化合物或抗菌药物进行化学预防。除特殊情况和高危宿主外，一般不鼓励进行化学预防。旅行者腹泻的自我治疗可成功限制腹泻病程，并将假期和工作时间的损失降至最低。目前的治疗选择，按有效性递增顺序包括凹凸棒石、含碱式水杨酸铋的化合物、洛哌丁胺、抗菌药物如氟喹诺酮类，以及洛哌丁胺与抗菌药物的联合使用。正在研究的有非吸收性抗菌药物利福昔明和新型钙调蛋白抑制剂扎尔达利德。针对产肠毒素大肠杆菌和志贺氏菌的疫苗研发和评估正在迅速推进，但尚未可供常规使用。
