How to Order ? Simple.
-
1.
Select Treatment
Choose from our treatment options or speak to the in-store pharmacist for advice
-
2.
Complete Medical Questionnaire
Complete our free online medical consultation to be reviewed by our Clinical Team
-
3.
Collect Medication from Local Pharmacy
We will notify you when your medication is ready for collection
Azithromycin Tablets from £20
Ciprofloxacin Tablets from £20
Advice for Traveller’s Diarrhoea
As many as 5 million people from the UK suffer from travellers' diarrhoea each year. It is a common condition affecting 20-50% of international travellers. It usually occurs during the first two weeks of travel to a foreign country, especially in the developing world where it can affect up to 60% of travellers. If travelling to North America, Europe, or Australasia it is generally no more of an issue than in the UK. Half of people who get travellers' diarrhoea will have to alter travel plans, and some will find that they have ongoing problems even after returning home.
Traveller's diarrhoea is usually caused by the ingestion of a bacteria, virus or parasite through food or drinks while on holiday or when travelling. Bacterial infections normally account for around 85% of cases. The organisms that cause traveller's diarrhoea include bacteria such as E. coli and Salmonella, parasites such as Giardia and viruses like norovirus.
Traveller's diarrhea causes sufferers to experience loose, watery stools and abdominal cramps. It can also often be accompanied by nausea, stomach pain, bloating, vomiting and/or fever. Although travellers diarrhoea is rarely serious it can be very unpleasant. Most cases will clear up independently without treatment within a few days, however, in some cases, a course of antibiotics may be needed to help ease symptoms.
At Pharmacinta, we can provide you with just the things to help battle unwanted episodes of diarrhoea. Both Ciprofloxacin and Azithromycin are antibiotics that are taken effectively for the treatment of traveler’s diarrhea.
Symptoms of travellers' diarrhoea are frequent runny stools that usually happen more than 3 times per day. It can also be associated with abdominal pain and cramps, nausea, vomiting, fever, and blood in the stools. Vomiting is uncommon, and abdominal cramps with blood or mucus in the stool is infrequent.
The symptoms of traveler’s diarrhea usually happen within the first week of travel. It typically is self-limiting, lasting three to four days during which time a small proportion of people can have it so bad that they become bedridden. In a minority of cases, the symptoms can last two weeks or longer. In rarer cases travellers' diarrhoea can lead to serious illness and even long-term bowel problems.
In approximately one percent of cases, symptoms persist for longer than a month. An episode of Traveller’s Diarhhoea, particularly one with severe symptoms, can lead to irritable bowel syndrome in a small number of sufferers.
When you are travelling and eating food and drink which may have been prepared in less hygienic conditions, your food and drink may easily have been contaminated and so give you diarrhoea.
The most common cause of traveler’s diarrhea are bacteria from the following:
- Escherichia coli
- Campylobacter
- Salmonella
- Shigella
However, it can also be caused by other bacteria, viruses, protozoa, parasites and toxins from foods. The most common viruses include norovirus and rotavirus. All these germs are spread through eating and drinking contaminated food and water, or using contaminated dishes and cutlery.
Loose stool can also be caused by a change in your diet such as eating oily or spicy foods.
Most travellers' diarrhoea will cause a relatively mild illness and it may not require any treatment beyond fluid replacement and a light diet - small amounts of foods such as rice or bananas which can be digested easily. It is important to keep well hydrated as you will be losing a lot of fluid.
Standby treatment is recommended for those who often experience diarrhoea while traveling abroad; travelers with bowel conditions such as IBS; travelers to destinations far from medical help; Travelers who have conditions which may be aggravated by severe dehydration/diarrhoea.
Travelers' diarrhoea can be a real pain, especially if you are in a location that is far away from any kind of medical treatment. Taking an antibiotic can significantly reduce the severity and duration of travellers' diarrhoea, but only if the diarrhoea is caused by bacteria. Both Azithromycin and Ciprofloxacin are available as a 'stand-by' medication to help treat the symptoms of traveler’s diarrhea. Ciprofloxacin is not recommended as the first line due to increased antibiotic resistance and rare severe side effects.
Azithromycin is a first-line antibiotic treatment for traveller’s diarrhoea caused by common bacterial infections. It is an antibiotic that kills diarrhoea-causing bacteria and reduces the symptoms and duration of this illness, especially when taken with loperamide.
Ciprofloxacin is an antibiotic treatment that is prescribed for killing the bacteria associated with travellers' diarrhoea. It can effectively reduce the duration of your traveller’s diarrhoea, as well as the symptoms associated with it. This effectiveness can be enhanced by the anti-diarrhoea drug loperamide, which can reduce the frequency of diarrhoea by reducing the spasm in the bowel and helping with cramps.
It is important to note that both Azithromycin and Ciprofloxacin should only be used to treat the symptoms of travellers' diarrhoea – it should not be used as a preventative measure.
Bacterial or viral infections are normally the cause of severe diarrhoea. You catch viral diarrhoea by direct contact and therefore you can prevent it by washing your hands regularly with soap and water. Whereas, bacterial diarrhoea normally comes from ingesting food or drink that has been contaminated.
Basic precautions that should be taken to avoid getting traveler's diarrhea include:
- Drink only safe water and beverages that have been boiled, bottled or distilled.
- Avoid tap water and hot drinks which have not been boiled.
- Avoid ice cubes as they may be made with contaminated tap water.
- Avoid ice-cream and other frozen desserts.
- Avoid raw fruit and vegetables that you have not peeled.
- Avoid salads as they may have been washed with contaminated water.
- Wash your hands before eating.
- Non-antibiotic medicines such Pepto-Bismol.
- Pre/Probiotics although there is not yet any convincing evidence that they are effective.
Sticking to bottled water even for things like cleaning your teeth, making ice cubes or rinsing fruit before you eat it can be helpful. Be careful when eating dairy products as they could be unpasteurised. Only eat food that is very hot and hasn’t been left out at room temperature. Be particular when eating food from street vendors and markets – hot food should have been kept hot and cold food should have been in a fridge.
Finally, you can also reduce your chances of getting traveller’s diarrhoea by cooking carefully. Keep cooked and uncooked food separate. Clean the worktops and utensils thoroughly and don’t prepare food if you already have diarrhoea.
In some more simple cases, travellers' diarrhoea can be treated with over-the-counter medicines. These medicines include Loperamide (Imodium) and rehydration sachets (Dioralyte). Using these products together will help ease the symptoms, this will help as your body is trying to fight off the infection. You must also ensure you remain hydrated so take on as much fluids as possible during this time, as dehydration is the most dangerous consequence of travellers' diarrhea.
Frequently Asked Questions
If you are in (or have very recently returned from) a developing/resource-poor country, and have developed diarrhoea (runny poo) more than 3 times a day, then this is probably travellers' diarrhoea. You may also have abdominal pain and cramps, nausea, vomiting, fever, and possibly blood in the stools.
Travellers' diarrhoea is most often caused by a bacteria, e.g. E.coli or campylobacter, whereas most diarrhoea at home is caused by viruses - e.g. rotavirus, norovirus. Diarrhoea can also be caused by other micro-organisms, both home and abroad, and also other things like medications, lactose, and fructose intolerance, artificial sweeteners, and medical and surgical conditions.
Travellers are more prone to developing diarrhoea if the hygiene conditions are worse than they are used to at home. Food and drink prepared in less hygienic conditions may easily have been contaminated, and so cause diarrhoea. Diarrhoea-causing bacteria can also be picked up on hands and without frequent hand washing or use of hand gel, that can also lead to diarrhoea. Local people have a tolerance to the local bacteria and, as their bodies have become used to them, they don't get diarrhoea.
The risk of travellers' diarrhoea is more in some countries than others: Low risk - Western European countries, USA, Canada, Japan, Australia, New Zealand. Intermediate risk - Southern European countries, Israel, South Africa, some Caribbean and Pacific Islands. High risk - Africa, Latin America, Middle East, most of Asia.
The most common cause is a bacteria- either E. coli or campylobacter. However, it can also be caused by other bacteria, viruses, protozoa, parasites, and toxins (bad chemicals) in foods.
It is most likely that you have developed diarrhoea due to eating or drinking contaminated food or water, that was prepared in a less hygienic environment. Sometimes the bug will come from your own hands, so good hand hygiene is essential when travelling.
As the bugs causing travellers' diarrhoea tend to be in food and drink, be careful with what you eat and drink. Stick to freshly prepared food that is thoroughly cooked and served piping hot. Drink only bottled (with intact seal) or 'clean' drinks. Don't have ice in your drinks. Don't use local tap water to clean teeth. Avoid street food or eating at places that appear dirty. Avoid ice cream, shellfish, salads, and cold foods in buffets. Avoid unpasteurized milk and cheese. Only eat fruit that you have peeled yourself. Take care when swimming and showering not to drink the water. Make sure you wash your hands or use hand gel frequently. Does Pepto-Bismol, Cola, or Whisky prevent travellers' diarrhoea? There is no evidence that taking Pepto-Bismol, coke, or whisky reduces the chance of getting travellers' diarrhoea.
There is no vaccine to prevent travellers' diarrhoea. Some travel vaccines prevent illnesses where there may also be diarrhoea, but they cannot prevent travellers’ diarrhoea itself.
If you have returned home and the diarrhoea is persistent after trying the suggestions above (How can I treat travellers' diarrhoea?) then contact your GP who may want you to send a sample of the diarrhoea for testing. Some diarrhoea is caused by other bugs which will require different treatments.
If the diarrhoea has not improved after 2-3 days of trying the suggestions above (How can I treat travellers' diarrhoea?) then get medical help. A doctor may test a sample of the diarrhoea to see if it is caused by other bugs (e.g. giardia), needing a different treatment. Occasionally after the original cause has gone, the intestine can take a long time to recover and so there is ongoing diarrhoea. This can happen if there was already a problem in the bowel or it could be because the cells which digest sugars have been damaged leaving an intolerance to lactose or fructose, or sometimes irritable bowel syndrome can be triggered by travellers' diarrhoea. If you are having prolonged symptoms of diarrhoea, even if triggered by an episode of travellers' diarrhoea, see your GP to discuss if further investigation is needed
If you are vomiting then Avomine, which is prescribed by Dr Fox for travel sickness, could also be taken to help to reduce fluid loss. Avomine cannot be used if also taking azithromycin. You are at more risk of developing dehydration if you are vomiting as well as having diarrhoea. Consider getting medical help sooner.
Consider where you want to take your holiday (Where am I at most risk of getting travellers' diarrhoea?). Consider being prepared by taking stand-by medication with you - Dr Fox can supply loperamide to treat the symptoms and azithromycin antibiotic to treat bacteria which are often the cause. Consider taking rehydration sachets or a rehydration spoon to make up your own rehydration solution, if you become unwell. Follow the advice about preventing travellers' diarrhoea.
Antibiotic preventative treatment is not normally recommended for travellers' diarrhoea as it may make you vulnerable to much more severe infections. In a very few 'high risk' travellers it may be offered. If you think you are in this group, then you should discuss your travel plans with your specialist or GP.
A mild travellers' diarrhoea will often improve within 2-3 days, with only fluid replacement and a light diet. More severe episodes can last longer and can cause ongoing gut issues for several days or weeks. Also see What if the diarrhoea doesn't settle?
Any gut infection can cause weight loss if it goes on for long enough. It is important to replace fluid loss by drinking 3-4 litres of clean fluid per day. You can and should continue to eat, but a light diet. You may not feel very hungry or feel sick as well, and so not eat as much as usual. This can also add to weight loss. If the diarrhoea is not settling and you are losing significant weight, consult a doctor. Also see How can I treat travellers' diarrhoea?
Travellers' diarrhoea usually starts about 6-7 days into a trip, but can start sooner or even much later, especially if you’re travelling through many countries.
Yes, mild cases can settle on their own, with drinking lots and eating a light diet. If it is more severe, persisting beyond 48 hours or worsening, then treatment should be considered.
In the past it was believed that resting the gut by starving would help to improve diarrhoea, but this approach has not been confirmed in studies. Advice now is to eat a light diet, avoid alcohol and caffeine, and drink lots of clean water.
You should see a doctor if: The diarrhoea is not improving within 24–36 hours despite self-treatment. You have a high fever over 38.5°C for more than 48 hours especially if you are in a malaria zone. You have persistent blood and green or yellow slime in the diarrhoea - you may need tests and a different type of antibiotic. You have severe abdominal pains - may indicate a more serious condition than straightforward travellers' diarrhoea. There is a rash - may indicate other more serious infections. You are becoming dehydrated and are unable to take enough fluids - you may need a saline drip if you can't drink enough.
Feeling very thirsty. Not passing urine more than four times a day. Urine that is a very dark yellow and smells strongly. Try to drink enough for it to be pale straw coloured during the day. Dry wrinkly skin, sunken eyes, dry mouth, lips and eyes. Feeling tired, dizzy or lightheaded, restless, irritable. For further information see NHS - Dehydration.
Azithromycin is the antibiotic of choice if you need to self-treat travellers' diarrhoea. The course is 500mg a day for 3 days. This is now the internationally recognised preference and has replaced the one-off dose of 1000mg of azithromycin or the use of ciprofloxacin for travellers' diarrhoea.
The Bristol stool chart is often used by doctors to help assess the level of diarrhoea or constipation. Travellers' diarrhoea is technically defined as 3 or more type 6 (fluffy pieces with ragged edges, a mushy stool) or 7 (watery, no solid pieces, entirely liquid) stools in 24 hours.
Potentially higher chance of side effects (mainly nausea), that can occur with a single dosage of 1000mg. By taking Azithromycin in divided doses (500mg daily for 1-3 days) may limit the adverse side effects. However, as with all other medication, not all individuals will experience side effects
Ciprofloxacin is not now recommended as an antibiotic for travellers' diarrhoea. It has become less efficient due to increased antibiotic resistance, and there are also reports of occasional severe side effects.
If you have a long journey, or an important meeting then taking loperamide will usually reduce the diarrhoea.
Take two loperamide capsules straight away. Then take one capsule after each episode of diarrhoea for up to 48 hours. Maximum 6 capsules per day. For further information read the loperamide patient leaflet.
Yes
Yes
There is no evidence that probiotics and live yoghurt will affect the course of the illness or prevent travellers' diarrhoea. They may help to replace the natural gut flora. With travellers' diarrhoea, the natural balance of gut microbes is altered, both by the diarrhoea and by any antibiotics taken.
If taking antacids for indigestion, azithromycin can be taken but leave at least 2 hours from the antacid as it will prevent full absorption of the azithromycin.
If you are pregnant, think you may be pregnant or if you are breastfeeding then you should seek medical advice from your doctor or one of our online doctors before you start taking this medication.
Yes. There are no interactions with alcohol and Azithromycin.
