@scdreamer - check to see whether there is a Passport Travel location near you:

https://www.passporthealthusa.com

Your new doctor needs to read the cdc pages. It's amazing to me how many docs don't do that! I wouldn't buy Rifamaxin OTC in India, and would be very cautious about Azythromycin.

Passport health is a good recommendation. Or, do you live near a medical school? Most have tropical medicine/travel medicine clinics.

Do you have your immunizations for India?

Agree with Kathie sometimes you need to push. When I asked my doctor about rifamaxin, he agreed didn't know much about it but agreed to do some research and after that he gave me the prescription. And I had a good pharmacist who was of Indian origin and told me that she knew lots of people who took it as a preventative. She also helped me get the dosage that was much cheaper and covered by my insurance (at least at the time).

We took Rifaximin starting the morning after we arrived in India until the day we left. No issues at all. Our travel doc has highly recommended it to her patients since it was approved as a preventative (it previously was used as a treatment and still is). She originally prescribed it mostly to high profile travelers -- performers, politicians, etc -- who couldn't afford to be sick even for a day, but now prescribes it to all her patients.

Even though we rarely have GI problems while traveling, we were impressed with our doc's statistics: 50% of her patients who don't take Rixamin get sick in India compared to 0% who do take it. Our primary doc also thought it was a good idea and several of our friends had taken it with success before us.(One friend had a story about six people who ate the same meal in Mumbai -- three not taking Rifaximin became violently ill and the other three were fine.)

Rifaxim was previously very expensive, but covered by our insurance. I believe it is now available as a generic both in Canada and the US. I don't remember our dosage, but I think we took it once a day with food. I agree that you shouldn't trust strangers on the internet for medical advice, but after living for years in Latin America, I do see this med as a breakthrough for travelers and it sounds as if your doc is on board. Enjoy your trip!

Feeling a bit stressed now - we are leaving in four days (counting the weekend - today is Saturday. We don't have the time available to make an appointment with a travel clinic - none are in our area, would require a whole day to get to one, even if we could get an appointment right away.

Of course, we had planned to get the Rx from our doctor over the last few weeks, as we had always done in the past - his sudden and untimely demise makes that impossible. (And we are actually mourning the loss, as he was a good guy and a part of our lives for many years.)

I am wondering if we should consult with an Indian doctor once we arrive - we will be in Delhi for the first four days, so we would have time to do that. An Rx procured from a chemist/pharmacy would be safe, yes?

Otherwise, we will just have to try to be careful. We have traveled in rural South America and Central America - my husband has resorted to his Cipro twice for food-borne infections, but so far I have not needed to. Obsessive hand washing, careful choice of foods and their preparation (as far as is possible) and alcohol-base hand sanitizer. I think that's our best bet for now.

So sorry about your doc. Surely someone is filling in for him. Or maybe you have a specialist (gastroenterologist?) who could help. If not, I would absolutely trust a Delhi hotel doc. The private Indian medical system is excellent.

Above all, I would not stress. You're going to have an amazing trip either way. Most American travelers don't take Rifaximin-- it's more of a 'thing' with Europeans. We did because we are adventurous eaters and our travel doctor was so gung ho. I'm sure we would have been fine without it.

We also chose not to eat meat or fish, which probably helped. And many extol the benefits of Pepto as a prophylactic (but remember it turns your tongue black -- don't let that freak you out!)

Have a wonderful trip.

Thanks for the words of encouragement, crosscheck.

I know - you'd think there would be another doctor filling in, but ours was a "country doctor" - private solo practice in our small town, and when he died, our insurance group assigned all his patients to new doctors in nearby towns. As it's only been a few weeks, the new doc my husband has seen once (an internist who insanely enough is either from India or Pakistan, not sure) is not willing to prescribe anything but the Cipro, and that very reluctantly. He doesn't know my husband at all, so it's not possible to convince him to reconsider. I don't even have a new doctor - will see the one I was referred to when we get back in late February.

Glad to hear that if we see an Indian doctor that our hotel can recommend, it will be okay. I am thinking we will just wait and hope we don't get sick - we shouldn't be so far away from medical care on this trip that we wouldn't be able to find a doctor.

I have a LOT of Pepto Bismol packed - have never taken it before, and didn't know about the black tongue part ... just heard that it makes your poop black, yikes.

Well we have received our supply of Rifaxmin from the pharmacy in Canada. We have 100 550 mg tablets. We have decided to start taking it upon arrival in Delhi, and see how we feel. We may taper down or discontinue depending on how we are feeling. We have made reservations at only hotel or highly recommended restaurants and will stay away from dairy, vegetables not cooked and the same with fruit.
the planning of this trip has been such fun but we are all anxious to get on our way in 8 days.

Have a great trip. We tapered down our dosage, I think we tried to take the equivalent of 300 or 400 mg, check the research on the dosage.

After seeing the meat and how it is kept, on many of our India trips we have just gone veg for the trip.

I hate to burst your bubble, but I think quite a few people on this forum have gotten sick after eating at the expensive, top-rated hotels and restaurants rather than the everyday places (not street food places).

julies:
I know there is no guarantee regarding getting sick but we hope that the hotel staff have been better trained on food handling and general sanitation.

We are off in 5 days

"we hope that the hotel staff have been better trained on food handling and general sanitation"

Good luck with that. I got sick (the only time I got sick) in a Taj Gateway hotel.

Hi ladyrep, You said you're taking the Rifaximin -- with that you really don't have to worry. We ultimately decided to take it because our friends -- and our doctor -- had become ill after eating in hotels and upscale restaurants. We were careful (no meat, fish, salads; lot of Purell), but otherwise we were cautiously relaxed about what we ate. We did have some market snacks and street food if okayed by our guides.

You are all so encouraging. There is not much worse than being sick on holiday, in a foreign country, and a hotel which your friends are out having a wonderful time.