Fecal-oral via ingestion of:
| Antibiotic | Dosage (adults) | Duration | Notes | |------------|----------------|----------|-------| | Azithromycin | 500 mg once daily | 1–3 days | First-line, especially in India (fluoroquinolone resistance high) | | Rifaximin | 200 mg TID | 3 days | Only for afebrile, non-bloody ETEC | | Fluoroquinolones (Ciprofloxacin) | 500 mg BID | 3 days | Avoid in SE Asia/India due to resistance |
Important: Antibiotics reduce duration from 4 days → 1.5 days. Do not use prophylactic antibiotics routinely (risk of C. diff, resistance). delhi-belly
Delhi Belly is a non-medical, informal term for Traveler’s Diarrhea (TD) . It is the most common travel-related illness, affecting 20–60% of international travelers to high-risk regions, including South Asia (India, Pakistan, Bangladesh), Southeast Asia, Africa, Mexico, and South America. While rarely life-threatening in healthy adults, it causes significant discomfort, dehydration, and disruption of travel plans.
| Severity | Symptoms | |----------|----------| | Mild | Few loose stools, no disruption of activities | | Moderate | Several loose stools, abdominal pain, altered plans | | Severe | ≥6 unformed stools in 24h + fever ± bloody stools (dysentery) | Fecal-oral via ingestion of: | Antibiotic | Dosage
| Myth | Reality | | :--- | :--- | | "Indians are immune." | No. Locals grow up with exposure to ETEC and develop partial immunity, but they still get diarrhea from novel pathogens. | | "Probiotics will save you." | They help a little, but they cannot defeat a high dose of ETEC. | | "Only cheap restaurants cause it." | False. Buffets at 5-star hotels are a common source (temperature abuse). | | "Get it over with early." | False. There is no "acclimatization diarrhea." Getting sick once does not protect you from getting sick again two weeks later. | | "Antibiotics are cheating." | No. Traveler's diarrhea is a medical condition. Treat it. |
1. Water is the enemy.
2. The street food strategy.
3. Protective supplementation.
4. The handwashing rule.