A 25-year-old PhD candidate recently traveled to Central America for 1 month to gain information regarding the socioeconomics of that region. While there, he took ciprofloxacin twice a day for 5 days for diarrhea. However, over the 2 to 3 weeks since coming home, he has continued to have occasional loose stools plus vague abdominal discomfort and bloating. There has been no rectal bleeding.
Which of the following therapies is most likely to relieve this traveler’s diarrhea?
A. Another course of ciprofloxacinPatients with symptomatic Giardia lamblia infection typically present with several weeks of bloating, loose stools, and weight loss. Most patients respond to metronidazole therapy. This parasite is contracted by ingesting contaminated food or water, with the classic zoonotic reservoirs being the freshwater streams of the northern United States and also the water supplies in Russia and developing countries. Bacterial pathogens such as Campylobacter jejuni, enterotoxigenic Escherichia coli, Salmonella, and Shigella usually cause acute diarrhea, often bloody. They usually respond to fluoroquinolones or azithromycin. Many bacterial pathogens in developing countries are resistant to trimethoprim-sulfamethoxazole. Oral glucose-electrolyte solution rehydration is the mainstay of Vibrio cholerae therapy. Hydration rather than antibiotics is also the key for enterohemorrhagic E coli.