Thanks for the wealth of info, guys.

Definitely will check with my doc next week, but most likely will just restock the Levaquin we had last year.

Have just been to India, besides vaccinations, we took with us a general antibiotic. It was recommended that we take copious quantities of Acidophilis tablets (they are completely natural) at least a week before we went. At least 3, three times a day. This fills the gut and bowel with good bacteria so that the bad cannot penetrate (hopefully) have also been told that Charcoal tablets are very good for tummy and bowel. Also our doctor gave us an eye antibiotic cream in case of any infections. We survived and all meds were intact on our return home! Yay!

For initial first aid, I now always travel with two homeopathic remedies recommended by my MD which have "saved" me on several trips, most notably when skiing in Megeve (those 4* restaurants can be brutal haha) and also in Costa Rico, Taiwan and Istanbul. Typically handles the acute symptoms (nausea, vomiting and diarrhea) and let my doctor test for and deal with any parasites present after returning home. Picked up a real nasty one in Taiwan at the Grand Hotel of all places.

Now, whenever consuming anything I consider questionable, I have had good success taking certain herbs to help deal with troublesome bacteria before they can cause issues.

If you're headed to India you could plan to drink lassi (yoghurt) when you get there, rather than popping pills beforehand.

A lassi is what did my H in and he had to go on the antibiotic and anti-nausea suppositories. TD is not the only problem you may encounter-not being able to keep anything down is dangerous also so the compazine is now a staple in our kit.

Things like Immodium are fine for you local, flu diarrhea but not traveller's diarrhea. Unpleasant as it is, you have to let the system rid itself of the bacteria, virus, or whatever you've contracted. Keeping it in allows it to multiply and get worse.

SAFE eating practices are essential. Lassis, yogurts, salads, fruits, cold or cool foods, Indian sweets, milk products, etc are BAD ideas. Be super picky about where and what you eat and drink!

Antibiotics are tricky because many of these GI bugs are not bacterial and the antibiotics will not kill the bug that's making you sick.

Anti-nausea meds should be ok, Tylenol or Motrin for aches, but anti-diarrheals are not such a good idea.

If it's bad, try to get to one of the larger private hospitals. Many docs there are US and Europe trained.

Who knew? I eat yogurt like it's going out of style each time I'm in Thailand (and boy oh boy do most hotels like to serve it for breakfast) and I've never had an issue there.

Milk products in India can be a problem.

I drank lassi in India with no ill effects. I would issue a warning about fruit juice - you need to be sure it is pure fruit juice, with no added water.

maybe its just better to stay home

Charcoal used to be given to Peace Corps volunteers as a treatment for parasitic infections. Don't know if it is still recommended. The Volunteers preferred charcoal to Flagyl because they couldn't drink while taking F.

Kathie,

So I just got back from my travel clinic (@ Cedars, whom I usually trust implicitly) and the doctor there gave me a Cipro prescription. I did tell her I heard that Azithromycin was recommended for where I was going and she said that in Thailand and India it is recommended, but for most of the rest of SE Asia the predominant bug is still e-coli (as opposed to the other bug which she named, but I can't remember for the life of me) and that Cipro not Levaquin is the most effective against that.

David went to his doctor (who didn't ask any travel-related questions, nor is affiliated with a travel clinic) and gave him a Levaquin prescription straight away when he explained what he was looking for.

Help! I'm confused more than ever.

I haven't filled my Cipro prescription yet, so I'm wondering if I need to call my doctor at the clinic back...?

Your question made me go back and research this again.

Let's see, you are going to Bali, Java and KL, right? For those places, Cipro is still ok. Levaquin is fine as well. For Thailand and Nepal and India, the situation is different. It turns out my original statement about Cipro no longer being effective in SE was incorrect. Some conservative travel med docs have stopped prescribing it for the whole of SE Asia, but others feel that it is fine for areas outside of Thailand, Nepal and India.

Here is the quote from the technical article on the cdc website:
"As bacterial causes of TD far outnumber other microbial etiologies, empiric treatment with an antibiotic directed at enteric bacterial pathogens remains the best therapy for TD. The benefit of treatment of TD with antibiotics has been proven in numerous studies. The effectiveness of a particular antimicrobial depends on the etiologic agent and its antibiotic sensitivity. Both as empiric therapy or for treatment of a specific bacterial pathogen, first-line antibiotics include those of the fluoroquinolone class, such as ciprofloxacin or levofloxacin. Increasing microbial resistance to the fluoroquinolones, especially among Campylobacter isolates, may limit their usefulness in some destinations such as Thailand, where Campylobacter is prevalent. Isolated anecdotal case reports of resistant Campylobacter diarrhea occur periodically from other destinations. An alternative to the fluoroquinolones in this situation is azithromycin. "

This is really helpful. Thanks, Kathie!!!

Filmwill,
My Travel Dr. told me the same thing....I asked for Azithromycin after telling him what I read on this site and he insisted on giving me Cipro. (However, I have a secret stash of Azithro from past sinus infections so I'm OK for both...guess if I get sick in Thailand it's Azithro and I''l take Cipro for Cambodia, Vietnam and Bali. I thought I was OK for all my shots....but turns out Typhoid is only good for 2 years, so had to get another one of that.

barefootbeach-I too discovered that my typhoid shot had "expired." This time around, I took the oral version--4 pills spaced out over a week. Supposed to be good for 5 years.