Dukoral is a ETEC (E. coli) and cholera vaccine (both of which can cause diarrhea), which you drink 2 doses preferably 1 week before you leave for your trip.

In response to Ag3046's comment on the overuse of antibiotics for travel, I recently attended a talk by a prominent Infectious Disease physician in Toronto who runs a big travel medicine clinic. His suggestion would be either Cipro or Zithromax (azithromycin) for traveller's diarrhea. He views it such that if you are paying thousands upon thousands of dollars on a trip where you really cannot afford to lose a day either sitting on or facing a toilet bowl, then taking the meds upon the first sign of symptoms is not that bad of an idea. The only real downside to all these antibiotic usage is the possibility of allergic reactions, drug resistance and the small risk of developing C.difficile infection (leading to more diarrhea).

Royal, I've never heard a travel med doc recommend the use of antibiotics at the first sign of travelers diarrhea. An antibiotic would only be effective if the symptoms were due to bacterial contamination. Most traveler's diarrhea is caused by dietary changes (new spices, more fruits than usual, different cooking oils) and would not respond to an antibiotic. I have heard some people maintain that it makes sense to take immodium or lomotil (anti-diarrheals) for symptomatic relief, with the caveat that of you have a bacterial infection or amoebic infection you may get sicker.

Dukarol , when taken orally, is to be taken in 2 doses. The first 6 weeks before departure and the second a week before. This according to our local Travel Medicine Clinic.

I think that one of the really important things to take is a small bottle of liquid hand sterilizer. My physician friend says that it should be used constantly while travelleling and is really important to use every time before eating.

..just a quick comment re immodium..use for first choice for diarrhea UNLESS fever or blood in stool (what a topic!). If so dont use it as can cause real problems (higher incidence of toxic megacolon)! Save antibiotics for the diarrhea which isnt controlled by immodium or if you have fever/blood. Dont use antibiotics obtained from a pharmacist without prescription unless you can find the generic on the label and are certain what is being given to you (and I would never be certain unless manufactured by an international drug company and taken from a sealed box).

Kathie, you are right about the most common causes of diarrhea during travel is usually poor judgement from the traveller in food choices (rather than an infectious cause). In fact, I often tell my own patients to wait a day or two before taking the antibiotics (and to try the imodium), or if the stools contain any blood or fever is present. Perhaps his opinion is not shared by other ID specialists.

Sorry about my confusion about the dukoral dosing. When I mentioned the 2 doses at least a week before departure, I forgot to say how far apart the 2 doses are taken (usually 1-6 weeks apart).

Lyndie - I reckon you have got it about right (tho no idea what Dukarol is!!)

And it's also true that you get more grief from a (probably plane caught) "cold" than from any exotic complaint. So I also carry a Vick inhaler. If you are going to somewhere really remote in Africa, take some high strength chloroquin or fansidar - FOR A MALARIA EMERGENCY - but not necessary in India.

I disagree absolutely with whoever it was that said that you should only take medicines that come in a box with the name of an international drug company on it. Look - unless you are really really sick (which you won't be unless you are travelling for months on a low budget and going to really out of the way places) then Indian pharmacists can offer help just like any others. And so many generic medicines for common complaints are available there - and much cheaper than at "home".

Why should anyone assume that if you buy vitamin C tabs from an Indian pharmacy somehow they aren't vitamin C?

Last but not least, Flagyl just handed out ïn the event of a "stomach complaint" sounds like a bad, or ill-informed practice to me.

Don't worry - just follow all the usual guidelines and you'll be laughing and drinking in all that India has to offer.

Personally, I would much rather bring all of my own meds from my home country before traveling overseas. I don't know if this applies to India pharmaceuticals, but I've heard numerous stories of places in China where you could buy drugs such as Viagra, other assorted antibiotics right off the shelf at considerably lower prices. The only problem is that some/most of the time, the so called drug might not even contain the actual active compound listed on the package. Thus, buyer beware.

You've heard stories? And you want to buy Viagra? nuff said.

One third of the anti-malarials purchased in SE Asia are counterfit or expired. India has similar problems.

Alice13, I'm not exactly sure what your point is in your last reply in this thread, but perhaps you should engage in some more educated reading on the ever growing prevalence of fake medications in Asia before you offer any further personal "opinions". See below if you don't know how to do a google search:

Time Magazine
http://www.time.com/time/asia/magazi...644218,00.html

BBC
http://news.bbc.co.uk/1/hi/world/asi...ic/1912170.stm

CBS News
http://www.cbsnews.com/stories/2000/...in204060.shtml

Viagra website
http://www.viagra.com/buyviagraonline/risks.asp

Asian Pacific Post
http://www.asianpacificpost.com/news/article/12.html

Asia Inc.
http://www.asia-inc.com/October04/bigpharma_oct.htm

China.org
http://www.10thnpc.org.cn/english/2003/Jan/52666.htm

People's Daily
http://english1.people.com.cn/englis...112_54922.html