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

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dc.contributor.author Vilkman, Katri
dc.contributor.author Lääveri, Tinja
dc.contributor.author Pakkanen, Sari H.
dc.contributor.author Kantele, Anu
dc.date.accessioned 2019-02-21T14:01:01Z
dc.date.available 2019-02-21T14:01:01Z
dc.date.issued 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 . https://doi.org/10.1016/j.tmaid.2018.06.007
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.identifier.uri http://hdl.handle.net/10138/299322
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 LACTAMASE-PRODUCING ENTEROBACTERIACEAE
dc.subject SELF-TREATMENT
dc.subject COLONIZATION
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.doi https://doi.org/10.1016/j.tmaid.2018.06.007
dc.relation.issn 1477-8939
dc.rights.accesslevel openAccess
dc.type.version publishedVersion
dc.type.version submittedVersion

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