- The Washington Times - Monday, May 16, 2005

HOUSTON (AP) — A drug used to treat a tourist’s worst nightmare — traveler’s diarrhea — also may prevent it without causing the antibiotic resistance that eventually can make medicines ineffective, new research suggests.

The study showed that the antibiotic rifaximin prevented the troublesome condition in about 85 percent of the people who took it.

The experiment involved 210 American students studying Spanish in Guadalajara, Mexico, during the summer of 2003.

Slightly less than 15 percent of the students who took rifaximin for two weeks suffered from diarrhea, while nearly 54 percent of those who took placebos came down with the illness, which also includes nausea, vomiting and stomach pain.

Antibiotics have been used for years to treat traveler’s diarrhea because it is caused by bacteria found in local food and water. Last year, the Food and Drug Administration approved rifaximin as a treatment for the illness.

The study — to be published today in the Annals of Internal Medicine — suggests it’s an effective preventive step as well.

“People who get decked all the time [by traveler’s diarrhea] tend not to travel,” said lead author Dr. Herbert DuPont, who works with the University of Texas Health Science Center in Houston and is chief of internal medicine at St. Luke’s Episcopal Hospital. “This would allow these people to enjoy a traveling life.”

The illness affects about 20 million international travelers a year, Dr. DuPont said. About 40 percent of those have a genetic susceptibility that makes them get no relief from over-the-counter treatments such as Pepto-Bismol.

Dr. Phyllis Kozarsky, a professor of medicine and infectious diseases at Emory University School of Medicine in Atlanta, said doctors generally don’t like to prescribe antibiotics as a preventive measure.

But, she said, rifaximin would be a good idea for people whose immune systems are compromised, who are traveling to developing countries for special events and can’t afford the risk of being downed by diarrhea, or “who travel frequently to Mexico and once they get on the plane, think, ‘Oh, gee, it’s just a matter of time.’”

A future study will focus on Thailand, where the bacteria that can cause diarrhea is more invasive than that found in Mexico, Dr. DuPont said.

“We have every reason to think it’ll work in Asia,” he said.

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