Stand-by antibiotics encourage unwarranted use of antibiotics for travelers' diarrhea : A prospective study

Show simple item record Vilkman, Katri Lääveri, Tinja Pakkanen, Sari H. Kantele, Anu 2019-02-21T14:01:01Z 2019-02-21T14:01:01Z 2019
dc.identifier.citation Vilkman , K , Lääveri , T , Pakkanen , S H & Kantele , A 2019 , ' Stand-by antibiotics encourage unwarranted use of antibiotics for travelers' diarrhea : A prospective study ' , Travel medicine and infectious disease , vol. 27 , pp. 64-71 .
dc.identifier.other PURE: 122516763
dc.identifier.other PURE UUID: 84da7aa1-1378-48c1-b11a-30cb2b41757e
dc.identifier.other WOS: 000457729300012
dc.identifier.other Scopus: 85048393373
dc.identifier.other ORCID: /0000-0003-4522-5337/work/54489665
dc.identifier.other ORCID: /0000-0002-1272-081X/work/54491195
dc.description.abstract Background: As antibiotics predispose travelers to acquiring multidrug-resistant intestinal bacteria, they should no longer be considered a mainstay for treating travelers' diarrhea. It has been claimed that stand-by antibiotics are justified as a means to avoid visits to local healthcare providers which often lead to polypharmacy. Method: We revisited the traveler data of 316 prospectively recruited volunteers with travelers' diarrhea by retrieving from questionnaires and health diaries information on antibiotic use, stand-by antibiotic carriage, and visits with local healthcare. Multivariable analysis was applied to identify factors associated with antibiotic use. Results: Among our 316 volunteers with travelers' diarrhea, however, carrying stand-by antibiotics seemed not to reduce the rate of healthcare-seeking; on the contrary, antibiotic use was more frequent among stand-by antibiotic carriers (34%) than non-carriers (11%). Antibiotics were equally taken for severe and incapacitating travelers' diarrhea, but compared to non-carriers, stand-by antibiotic carriers resorted to medication also for mild/moderate (38% vs. 4%) and non-incapacitating disease (29% vs. 5%). Antibiotic use was associated with stand-by antibiotic carriage (OR 7.2; 95%CI 2.8-18.8), vomiting (OR 3.5; 95%CI 1.3-9.5), incapacitating diarrhea (OR 3.6; 95%CI 1.3-9.8), age (OR 1.03; 95%CI 1.00-1.05), and healthcare visit for diarrhea (OR 465.3; 95%CI 22.5-9633.6). Conclusions: Carriage of stand-by antibiotics encouraged less cautious use of antibiotics. Recommendations involving prescription of antibiotics for all travelers require urgent revision. en
dc.format.extent 8
dc.language.iso eng
dc.relation.ispartof Travel medicine and infectious disease
dc.rights cc_by_nc_nd
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Travelers' diarrhea
dc.subject Stand-by antibiotics
dc.subject Travel
dc.subject Severe TD
dc.subject Incapacitating TD
dc.subject Antimicrobial resistance
dc.subject LOPERAMIDE
dc.subject RISK
dc.subject ABROAD
dc.subject COHORT
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.subject 3111 Biomedicine
dc.title Stand-by antibiotics encourage unwarranted use of antibiotics for travelers' diarrhea : A prospective study en
dc.type Article
dc.contributor.organization Department of Bacteriology and Immunology
dc.contributor.organization University of Helsinki
dc.contributor.organization Medicum
dc.contributor.organization Infektiosairauksien yksikkö
dc.contributor.organization Clinicum
dc.contributor.organization Department of Medicine
dc.contributor.organization Anu Kantele-Häkkinen Research Group
dc.contributor.organization HUS Inflammation Center
dc.description.reviewstatus Peer reviewed
dc.relation.issn 1477-8939
dc.rights.accesslevel openAccess
dc.type.version publishedVersion
dc.type.version submittedVersion

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