Travelers' diarrhea: Prevention, treatment, and post-trip evaluation

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Antibiotic prophylaxis is available, but may not always be desired or warranted. What are the options for preventing travelers' diarrhea and equipping patients for self-treatment?A 40-year-old female patient, a childhood immigrant from India, is seeking advice regarding her upcoming 2-week trip to Mumbai. She is taking her 2 children, ages 16 years and 16 months, to visit their grandparents for the first time. She has made this trip alone a few times and has invariably experienced short bouts of self-limited diarrheal illness. She wonders what she might do to prevent travelers' diarrhea. Her only medical problem is rheumatoid arthritis, which has been well controlled with methotrexate. Her children are healthy. What would you recommend?

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