Reisediarrhö: Ursachen, Therapie und Prävention

Traveler’s diarrhea (TD) in children is common during trips to developing countries and is caused mainly (50–80%) by bacterial pathogens. The incidence rates show considerable variations and are highest in Africa and countries in southeast Asia. Compared with older children and adults, TD in infants and young children is more severe and prolonged. Most cases of TD are mild and self-limiting. Typical symptoms include watery diarrhea, nausea, and abdominal cramp pain. Young children are more likely to present with fever and bloody stools and have prolonged symptoms more often than older children and adolescents, which require antibiotic treatment. Correcting dehydration and replenishing volume losses are paramount in the management of TD particularly in young children. Oral rehydration solutions containing appropriate amounts of glucose and electrolytes are an important component in the management of children with TD. Data on the use of antidiarrheal agents for TD in children are limited. Antibiotics are not routinely recommended but should be given in severe and protracted TD. Preferred agents for TD are azithromycin for children and ciprofloxacin for older children and adolescents. Data for prophylactic dietary measures and recommendations are very limited; however, the influence on the incidence of TD seems to be marginal. In general, there is a substantial lack of data and evidence regarding TD in children.