Traveler's Diarrhea

Prevent this malady by CAREFUL eating and drinking! Boil it, cook it, peel it, or forget it! Watch green salads and ice. If you are unlucky enough to get this illness, you can take an antibiotic, which may lessen the severity. We do not recommend taking antibiotics for prevention. If you get diarrhea, take over the counter Imodium and Kaopectate. Also consider:

Cipro (ciprofloxin)
A broad-spectrum antibiotic. Can cause upset stomach, possible photosensitivity. Avoid if  pregnant or under the age of 16. Cipro is expensive. Take one 750 mg tablet as treatment. Don’t take with theophylline. Septra may be better for those under the age of 16.

Septra (trimethoprim-sulfamethoxazole)
A long-time standby, but more bacteria have resistance to this sulfa antibiotic. Usually well tolerated (more so than Cipro). Okay in 2nd trimester only. Price is less expensive. Check for allergy to sulfa. Take one Septra DS (or generic) tablet every 12 hours for 6 doses.

Malaria Prevention

Malarone
A combination drug (atovaquone/proguanil) that is taken daily. Expensive ($7/tab), but with fewer side effects than Lariam. A 10-day trip is $115. Take with food at same time each day. Start two days before, daily during and for seven days after exposure to malaria. 98% effective and good for resistant areas. Pediatric doses available.

Lariam (mefloquine)
This is the drug most frequently used since chloroquine resistance is so widespread. Can cause vivid dreams, neuropsychiatric reactions, GI and other side effects. Not for pregnant women, epileptics, or children under 30 lbs. Be cautious when consuming with alcohol. Take one 250 mg tablet weekly (with food and 8 ounces of water) starting 2½ weeks prior to exposure, weekly during exposure and for four weeks after exposure. Cost is $9 a tablet. Cost: about $70 for 10-day trip. Many will prefer Malarone despite its higher cost.

Doxycycline (tetracycline)
Used in Thailand and other areas with Lariam resistance. 100mg a day start two days prior to exposure and for four weeks after exposure. Watch for stomach ache, sun reaction and skin rash. Inexpensive.

See Malaria, Lariam and What to Do for more information.

Altitude Sickness

Travelers to high altitudes (over 10,000 feet) may wish to take medication to prevent altitude sickness.

Diamox (acetazolamide)
A diuretic related to sulfa. Don't give to sulfa-allergic persons. Take one tablet (125 mg or 250 mg) twice a day starting 12 hours prior to being at altitude and continue until low elevation regained.

Pre-Travel Health Screening Form

To make your office visit more efficient, download and print out the following two-page form. Please fill it out before your appointment and bring the form with you. (You will need Adobe Acrobat Reader to view this form).