Traveler's Diarrhea &
Travel Medications NYC
Getting sick abroad is common, and preventable or manageable with the right preparation. At your pre-travel consultation, we prescribe standby medications tailored to your destinations so you're equipped to treat common travel illnesses on your own, even far from medical care.
Traveler's Diarrhea: What You Need to Know
Traveler's diarrhea (TD) affects 20–50% of international travelers and is the most common travel-related illness. It is caused primarily by bacterial pathogens, most often enterotoxigenic E. coli, transmitted through contaminated food and water.
High-risk destinations include South and Southeast Asia, Sub-Saharan Africa, Latin America, and the Middle East. Even careful travelers in these regions can be affected - the risk comes from the local water supply, which affects ice, produce, and restaurant food in ways that are difficult to fully avoid.
The most effective approach is a standby antibiotic prescription that you carry with you and take at the first sign of significant diarrhea. Starting antibiotics early, before symptoms become severe, dramatically shortens the course of illness and reduces the risk of complications. Your physician will prescribe the right antibiotic for your destination based on current regional resistance patterns.
High-Risk Destinations for TD
- 🌏 South Asia - India, Nepal, Pakistan, Bangladesh
- 🌏 Southeast Asia - Thailand, Vietnam, Indonesia, Cambodia
- 🌍 Sub-Saharan Africa - Most countries
- 🌎 Latin America - Mexico, Central America, Andean countries
- 🌍 Middle East & North Africa - Egypt, Morocco, Turkey
Travel Medications We Prescribe
All prescription medications require a physician visit. At your consultation, we build a customized travel medical kit based on your destinations, activities, duration, and health history.
| Medication | Used For | When to Start | Notes |
|---|---|---|---|
| Azithromycin | Traveler's diarrhea (standby) | Take if needed during travel | Preferred for Asia; effective against most bacterial TD pathogens |
| Ciprofloxacin | Traveler's diarrhea (standby) | Take if needed during travel | Alternative to azithromycin; increasing resistance in South/SE Asia |
| Rifaximin | Non-invasive E. coli diarrhea | Take if needed | Not for use with fever or bloody stool; minimally absorbed |
| Malarone (atovaquone-proguanil) | Malaria prevention | 1–2 days before entering endemic area | Daily tablet; well tolerated; start just before travel |
| Doxycycline | Malaria prevention | 1–2 days before; continue 4 weeks after | Daily; inexpensive; avoid prolonged sun exposure |
| Acetazolamide (Diamox) | Altitude sickness prevention | 1–2 days before ascent | For travel above 8,000 ft; review sulfa allergy history |
| Ondansetron (Zofran) | Nausea and vomiting | As needed | Useful for severe TD-related nausea or motion sickness |
| Ibuprofen / Analgesics | Pain, fever | As needed | OTC; we advise on appropriate formulations for destination |
Food & Water Safety for Travelers
Drink only sealed bottled water or water that has been boiled or treated. Avoid ice in drinks, as it is often made from tap water. Use bottled water for brushing teeth in high-risk destinations.
"Boil it, cook it, peel it, or forget it." Eat hot, freshly cooked food. Avoid raw vegetables, salads washed in tap water, and food from street vendors unless it's cooked to order in front of you.
Frequent handwashing with soap and water or alcohol-based hand sanitizer significantly reduces transmission of enteric pathogens. Carry hand sanitizer and use it before eating.
Traveler's Diarrhea FAQ
Do I need a prescription for traveler's diarrhea antibiotics?
Yes. Antibiotics for traveler's diarrhea, including azithromycin, ciprofloxacin, and rifaximin, require a prescription. We provide standby prescriptions at your pre-travel consultation so you have the medication on hand if needed during your trip. You should not attempt to obtain these antibiotics without a physician review of your destination and health history.
Is traveler's diarrhea dangerous?
Most cases of traveler's diarrhea are self-limiting and resolve within a few days. However, severe diarrhea causing significant dehydration - especially in children, elderly travelers, or those with underlying conditions, can become serious. Infections with organisms like Giardia, Cryptosporidium, Shigella, Salmonella, or E. coli O157 can cause prolonged or severe illness requiring medical attention.
What's the difference between Cipro, Azithromycin, and Rifaximin?
Ciprofloxacin (Cipro) is a fluoroquinolone effective against many bacterial causes of TD, but resistance is increasing in South and Southeast Asia. Azithromycin is now preferred for travel to Asia and is generally more broadly effective. Rifaximin is minimally absorbed and works only for non-invasive E. coli diarrhea - it's not appropriate if you have fever or blood in stool. Your physician will prescribe the right antibiotic for your destination.
Should I take bismuth subsalicylate (Pepto-Bismol) preventively?
Bismuth subsalicylate can reduce the incidence of traveler's diarrhea by roughly 50% when taken preventively, but it requires taking large quantities (two tablets four times daily) and is not suitable for everyone. It is not generally recommended as a routine preventive strategy. We'll discuss the tradeoffs at your consultation.
What about altitude sickness medication?
Acetazolamide (Diamox) is the standard medication for altitude sickness prevention and is prescribed at your consultation for travelers heading above 8,000 feet. It should be started 1–2 days before ascending to altitude. We'll review contraindications and dosing at your visit.
Get Your Travel Medications Before You Go
Available Monday–Thursday 8 am–5 pm, Friday 8 am–3 pm. Located steps from Washington Square Park, Manhattan.
Book an Appointment Or call us: 212-982-1600