Prevention of traveller’s diarrhea: comparison of different non-antibiotic preparations

This investigation was carried out to evaluate the value of four different non-antibiotic preparations for prophylaxis or treatment of traveller's diarrhea. All studies were placebo-controlled double blind field trials with Austrian tourists visiting countries with warm climates. Lactobacillus acidophilus and Dodecoral, containing killed micro-organisms for oral immunisation, did not exhibit any prophylactic activity. When treating patients suffering from traveller's diarrhea with Noventerol, a preparation containing various non-specific antidiarrheal agents, no influence on its clinical course could be observed. Only application of Saccharomyces cerevisae (strain Hansen CBS 5926*) decreased the incidence of diarrhea significantly. Attack rates of diarrhea in the placebo treated group, group 1 (2 x 125mg Saccharomyces daily) and group II (2 x 250mg Saccharomyces daily) were 42.6 per cent, 33.6 per cent and 31.8 per cent respectively. This reduction was statistically significant (p<0.002). Dose dependency is suggested but not significant in this study. When evaluating the prophylactic efficacy in different geographical areas it could be shown that the reduction of risk amounted to 58, 59 and 40 per cent respectively in northern Africa, western Africa and various tropical islands. This reduction of incidence (p<0.0025 of p<0.01 and p<0.05, respectively) was significant compared with the overall risk reduction rate. As different protection rates according to the destination of travellers were observed, a selective efficacy of S. cerevisiae has to be taken into account.