Traveler's Diarrhea Treatment Contributes to Superbug Spread

Treating traveler’s diarrhea with antibiotics may contribute to antibiotic resistance and spread resistant bacteria strains, particularly if travelers visit developing parts of the world.

“More than 300 million people visit these high-risk regions every year,” said lead study author Anu Kantele, MD, PhD, associate professor in infectious diseases at Helsinki University Hospital in Finland, in a press release. “If approximately 20% of them are colonized with the bugs, these are really huge numbers. This is a serious thing. The only positive thing is that the colonization is usually transient, lasting for around half a year.”

The researchers tested stool samples from 430 Finnish travelers for resistant bacteria that produced extended-spectrum beta-lactamase (ESBL). They also looked for risk factors that might contribute to bacterial colonization, such as diarrhea and antibiotic use.

The travelers were tested before and upon their return from tropical or subtropical regions. Overall, 21% of travelers unknowingly contracted ESBL-producing bacteria during their trips, and 37% of travelers who took antibiotics for diarrhea were colonized.

Traveling to South Asian regions presented the highest contraction risk: 80% of travelers who took antibiotics for diarrhea while traveling to those regions contracted ESBL-producing bacteria.

As a result, the study authors recommended educating international travelers about antibiotics, as well as nonantibiotic methods of treating mild diarrhea. The authors specifically cited OTC antidiarrheal drugs for symptom relief.

“The great majority of all cases of travelers’ diarrhea are mild and resolve on their own,” Dr. Kantele said in a press release.

Although travelers might not develop resistant infections, they may unknowingly spread the superbugs within their home countries, researchers determined.

The study was published online January 22, 2015, in Clinical Infectious Diseases.