Download Travellers` Diarrhoea

PATIENT INFORMATION LEAFLET
Travellers’ Diarrhoea
Your Pharmacist can advise you about travellers’ diarrhoea and supply you
with an antibiotic called Xifaxanta.
Travellers’ diarrhoea is an infection which usually last about 3 days.
Xifaxanta is an antibiotic which reduces the length of diarrhoea symptoms
SPECIMEN ONLY
by about a half.
Taking Xifaxanta
Xifaxanta tablets (rifaximin 200 mg) are taken once three times daily for
three days.
Xifaxanta should be started as soon as diarrhoea appears (3 or more
unformed diarrhoea
motions in 24 hours).
It toistreat
antravellers’
offence
and invalidates
pharmacy
People can carry Xifaxanta with them on a trip
diarrhoea
Xifaxanta
is
for
simple
travellers’ diarrhoea. It is not suitable for more
if it arises.
insurance to use PGDs without valid rights.
serious infections. Self treatment is not suitable for people with existing
The risk of suffering with travellers’ diarrhoeaAnnual
varies fromtraining
one countryand
to payment
is required
medical conditions,
such asfor
diabetes, or for people with a history of bowel
another. People on short business trips may not be able to afford time off
disease, who should seek medical help if they get travellers’ diarrhoea.
our
PGDs
to
be
valid.
with illness. People travelling on a budget (rough travel) may be exposed
to infection. Whether to carry Xifaxanta on a trip is a personal decision.
Risks
Up to half of people from the UK who travel to some parts of the world will
get travellers’ diarrhoea. As many as 5 million people from the UK suffer
each year. Travellers’ diarrhoea usually starts within the few days of arriving
in a new country.
High risk (about 40%) areas include Africa, the Indian subcontinent (India,
Bangladesh and Pakistan), South America and much of China. Medium
risk (8-15%) areas include Russia, The Middle East, The Caribbean Islands,
South Africa, Thailand and parts of China. There is even a low possibility
of travellers’ diarrhoea in Eastern and Southern Europe. Trips to Western
Europe, North America including Canada, and Australia and New Zealand
are generally considered safe.
Causes of travellers’ diarrhoea
Travellers’ diarrhoea is usually caused by ordinary bugs (bacteria) which
our bodies are just not used to. These new bacteria upset the balance the
digestive system and can cause diarrhoea and other symptoms. Some
travellers’ diarrhoea is caused by different and more serious infections.
Symptoms
Travellers’ diarrhoea symptoms include watery stools, stomach cramps, and
sometimes vomiting, loss of appetite, temperature and a loss of energy.
The symptoms usually last for a few days. During those few days, a person
may be unable to travel or work.
More serious travellers’ diarrhoea symptoms include rashes and high fevers,
bloody diarrhoea, severe tummy cramps, and sometimes dehydration.
Sometimes symptoms do not settle for weeks or even months, and in rare
cases damage to the digestive system can be life-long.
Avoiding infection
To reduce travellers’ diarrhoea risk:
•
•
•
•
•
•
Avoid street food or places which appear dirty
Drink bottled or boiled drinks
Peel fruit or remove the skins
Avoid shellfish and salads
Be careful about hand washing
Ice cream and ice can be a source of infection
Treatment
Travellers’ diarrhoea usually improves within a few days and is usually gone
after three days.
If travellers’ diarrhoea starts whilst you are already taking an antibiotic, talk
to a doctor before taking Xifaxanta.
Do not take Xifaxanta without talking to a doctor
• if you have a fever
• if you have blood in your stools
• if you passed 8 or more unformed stools in the last 24 hours
Seek medical attention
• if, after 3 days of treatment, your symptoms continue or re-appear
shortly afterwards, do not take a second course of Xifaxanta, see a
doctor
• if your symptoms get worse during treatment, stop taking Xifaxanta
and consult a doctor
• if you get a rash or high fever consult a doctor
Alternative antibiotic treatments
Xifaxanta is a standby treatment to carry on a trip. It is to be used only to
treat diarrhoea once it starts. There are other mediations which can be
taken beforehand to prevent travellers’ diarrhoea from starting. Some
people with existing medical problems may be advised by doctors to take
medications to prevent travellers’ diarrhoea from starting.
Alternative standby antibiotics to treat travellers’ diarrhoea, usually either
ciprofloxacin or azithromycin, are sometimes given instead of Xifaxanta.
These antibiotics are similar in their effectiveness for simple travellers’
diarrhoea and are also used when travellers’ diarrhoea is more serious.
Side-effects
The great majority of people taking Xifaxanta do not have side-effects. A
small number of people report: dizziness, headache, wind, abdominal
bloating, abdominal pain, constipation, and diarrhoea, urgency to
evacuate faeces, nausea, involuntary and painful or ineffective straining,
vomiting and fever. Other side-effects occur less commonly.
Who should carry Xifaxanta?
The decision whether to carry Xifaxanta is a personal one for each person.
• Risk of infection varies from country to country (as above)
• People on tight schedules may not be able to afford a period of illness
e.g. business travellers
• Budget travellers may be at more risk (rough travel and increase
exposure to infection)
• People undertaking prolonged travel will have greater exposure to
infection
The mainstay of treatment is rehydration and rest. Fluid is lost from the
body and this must be replaced. Drink at least 3-4 litre (4-6 pints) of fluid
per day. This fluid could be water or preferably rehydration fluid, which can
be made up from pre-bought sachets or made by adding 6 level teaspoons
of sugar and half a teaspoon of salt to a litre of cleaned boiled water.
Further information
Taking the antibiotic Xifaxanta is likely to shorten diarrhoea symptoms by
about a half.
Information about travellers’ diarrhoea can be found at NHS
Choices website (www.nhs.uk/conditions/travellersdiarrhoea/) and
TravellersDiarrhoea.co.uk.
Anti-diarrhoeal tablets, such as loperamide, which reduce spasm in the
bowel, can reduce the frequency of diarrhoea. Loperamide can be taken at
the same time as Xifaxanta.
Information about taking Xifaxanta is provided in the manufacturer’s
patient information leaflet supplied with your tablets. You MUST read this
leaflet before taking your tablets.
Note: Your Pharmacist can provide general travel advice, but NOT a full
travel clinic service.
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