title: Nonantibiotic therapy for travelers' diarrhea.
abstract: Several trials have shown that nonantibiotic drugs are efficacious in the treatment of travelers' diarrhea. When compared with placebo (P less than .025), bismuth subsalicylate (Pepto-Bismol) taken orally at a dosage of as low as 30 ml every half hour for eight doses was shown to be effective in reducing the frequently of episodes of diarrhea. Preliminary results indicated that loperamide (two 2-mg capsules followed by one capsule after each loose bowel movement) was more effective (P less than .025) than bismuth subsalicylate in relieving diarrhea. Likewise, preliminary results showed that BW942c, an unlicensed endorphin-like pentapeptide, offered more relief of diarrhea in the first 12 hr of therapy than did trimethoprim-sulfamethoxazole (P = .02) or placebo (P = .0007). Use of a nonantibiotic drug for empiric treatment of travelers' diarrhea appears to be a reasonable approach, especially for patients with mild to moderate disease and with no evidence of high fever or dysentery.
mesh_terms: D000930:Antidiarrheals / Q000627:therapeutic use*; D001729:Bismuth / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003967:Diarrhea / Q000188:drug therapy*; D004338:Drug Combinations / Q000627:therapeutic use; D004744:Enkephalin, Methionine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004745:Enkephalins; D006801:Humans; D008139:Loperamide / Q000627:therapeutic use; D009942:Organometallic Compounds; D012459:Salicylates / Q000627:therapeutic use; D013420:Sulfamethoxazole / Q000627:therapeutic use; D014195:Travel; D014295:Trimethoprim / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
chemical_list: D000930:Antidiarrheals; D004338:Drug Combinations; D004745:Enkephalins; D009942:Organometallic Compounds; D012459:Salicylates; D004744:Enkephalin, Methionine; C015715:bismuth subsalicylate; D008139:Loperamide; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; C045617:BW 942C; D014295:Trimethoprim; D013420:Sulfamethoxazole; D001729:Bismuth