advice from travel clinic
 

I just went to the travel clinic to get my vaccinations for Thailand.
They prescribed Zithromax (antibiotic) to treat travelers diarrhea, saying that Thailand is immune now to Cipro. Does anyone know if this is true? My husband's primary care doctor gave him a prescription of cipro to take and I'm wondering if it won't work there (in case one of us gets sick).

We were also told that Cipro is not effective in Thailand (due to overuse), so we are taking both, since we are going to Cambodia and Vietnam as well, and Cipro is effective in those countries.

We took Cipro with us and everyone I know who has traveled since last year has taken Cipro with them.

But do realize, Cipro (and maybe this Zithromax) is not for simple diarrhea, rather "bacterial" diarrhea. For simple "tummy grippers" the over-the-counter stuff works fine.

How one self-diagnoses which is which, I have no idea, but with an antibiotic you can't take just one pill, but have to take the entire dosage for a period of, I believe, 5-days.

So unless either of you are bent over in unbearable pain and can't move, for which you should get to a doctor, I wouldn't be popping antibiotics too readily. Definitely have some of the OTC stuff with you.

We took Cipro last year in Thailand when we developed traveler's diarrhea, which we either picked up in Cambodia or at dinner in Thailand. It seemed to be effective and took care of the diarrhea.

Listen to the experts at the travel clinic. It's their job to stay up to date on what works best where, more so than a primary care physician, and certainly more so than antecdotal evidence picked up on an internet board. If you're uncertain, or want to bring up some of the good points raised above, I highly recommend you ask the doctor at the travel clinic.

And please do ask your doctor how to determine when to take an antibiotic. While it is wise to have a good, broad spectrum antibiotic with you, there is rarely a need for it. Your doctor can give you guidelines for when to take it and how many doses depending on the type of infection.

Amen, Kathie.

thanks to you all. I'm still perplexed as the travel clinic I saw had a travel nurse (there is no dr. there to see) who does specialize in this. My husband's dr is a primary care doctor but specializes also in travel medicine. I've called both, both claim they're right so I'm not sure what we'd take if (hopefully won't) we do get sick.
And I've obtained directions of how and when to take the antibiotic. unfortunately, i'm prone to stomach illness so have been through this before elsewhere--and will be more prepared this time!

Check out IAMAT at www.iamat.org This is a network of physicians around the world who speak English.

Membership is free, its a nice resource and you may be able to contact an IAMAT member Dr in Thailand to get advice "from the source"

the first best medicine in my opinion is to watch what you eat and drink!!!! we have been to thailand 5 times, malaysia once, singapore once, myanmar once, and vietnam once...we have never had a problem of any kind....we do however eat very carefully and drink ONLY bottled water, even in 5 star hotels (ok, so last year we loosened up a bit and did drink table water at the peninsula, but never before)...we only eat things that have been cooked, never eat green salads, never have ice on any kind, take lettuce out of mcdonalds big macs if they put it in after we ask for it to not be put in, eat only fruit that you have peeled...rarely eat at buffets, except at top hotels...

we eat mostly at hotels or upscale restaurants or restaurants for tourists...we are constantly on gueard---REASON WE DO NOT WANT TO RUIN ONE MINUTE OF OUR VACATION....call us extreme, but it works....it works period.....

oh yes, NO STREET VENDORS, absolutely none...

follow this and your chances of needing the medicine is slim....

Bob's advice about prevention is excellent. The only thing I'd add it to wash your hands before you eat anything. Observing water precautions is the most important prevention for gastro-intenstinal upsets. I have to admit that I eat salads at 5* places in Bangkok (we all decide what risks we'll take). I've been traveling to third world countries for over 20 years, and I've never gotten sick. While I do carry antibiotics from my travel medicine clinic, I have never had to use them in a foreign country. (Once, I started developing pneumonia in Aspen, Colorado and appreciated that I had my international travel kit with me!)