Travelers' preferences for the treatment and prevention of acute diarrhea.

Background: A survey was designed to assess travelers' willingness to take antibiotic chemoprophylaxis against travelers' diarrhea (TD) or to intervene with antibiotic or symptomatic treatments.

Methods: A brief written questionnaire was administered to clients in North American (United States and Canadian) and European (UK and German) travel clinic waiting rooms to assess length, purpose, and destination of their upcoming trips; their perceived risk of developing TD at their destination; and their preferences for hypothetical treatment or chemoprophylaxis options, which included descriptions, but no mention of brand names, of a systemically absorbed antibiotic based on a fluoroquinolone, a nonabsorbed antibiotic based on rifaximin, and an over-the-counter antidiarrheal similar to loperamide.

Results: The 209 UK and German travelers planned significantly longer travel than the 277 US and Canadian travelers (25 vs 15 d, p < 0.

Clostridium difficile colitis that fails conventional metronidazole therapy: response to nitazoxanide.

Objectives: Clostridium difficile-associated disease has increased in incidence and severity. Recommended treatments include metronidazole and vancomycin. Recent investigations, however, document the failure of metronidazole to cure a substantial proportion of patients with Clostridium difficile colitis, but oral administration of vancomycin raises concerns over selection of antibiotic-resistant organisms in the hospital environment.