Table 2

Guidelines for the prevention and management of travellers’ diarrhoea (TD)

Strength of recommendation
Guidance: prevention
    All team members receive written advice regarding the prevention of TD prior to travel (to cover hygiene, food and drink choices)Strong
    All team members receive oral advice regarding the prevention of TD (to cover hygiene, food and drink choices)Strong
    All team members issued with alcohol hand gel and instructed in its useStrong
    Ciprofloxacin prophylaxis for all non-competing team membersStrong
    Rifaximin prophylaxis for all competing team membersConsider (good evidence in non-athletic populations)
    Probiotics for all team membersConsider (but no clear supporting evidence)
Guidance: management
    Simple TD managed with fluid and electrolyte replacement with or without loperamideStrong
    Significant TD managed as for simple TD with the addition of empirical antibiotics as per local advice, after a stool culture is obtainedStrong
    Isolate cases of TD where possibleStrong