Revista de Medicina Desportiva (English) September 2018 | Page 7
targeted therapy. On those cases
where rapid results are urgent or
when the non-molecular tests fail to
identify the microorganism, mole-
cular tests should be done. However,
they won’t show the sensitivity of
the microorganism to the different
antibiotics. On the other hand, the
coprocultures can be positive for
colonized microorganisms, com-
promising the interpretation of the
results, which makes the clinical
findings crucial.
Recent studies have shown some
role, albeit marginal, of the pre and
of the probiotics for prevention and
therapy of the TD. However, the
evidence is still scarce to routinely
recommended it.
The adequate, and not exagge-
rated, prophylaxis and therapy of
TD are considered fundamental in
these recommendations, not only
to restore the well-being of the
individual, to keep the plans traced
for the travel, as well as to avoid
the consequences, often chronic,
which may exist on the long-lasting
intestinal symptomatology. Of these,
it is highlighted the post-infection
syndrome of irritable bowel, whose
diagnosis may be based on the Rome
IV criteria, in which a previously
gastrointestinal healthy individual
maintains symptoms of abdominal
pain, diarrhea and/or constipation
after an episode of TD, where the
microbiological investigation and
other underlying pathologies of the
gastrointestinal tract are negative.
Comment
Nowadays, where every corner of
the world is at a distance of a snap
fingers, and where perhaps the
technology has evolved faster than
the Human body, it becomes more
urgent that medicine pay attention
and progresses with regard to dis-
eases and conditions inherent to the
mobility of the persons around the
four corners of the world.
The revolution of these recommen-
dations, based on the classification
of the TD according to its functional
impact, implies, in the meantime,
that health care system is focus in
the training of the traveler during
the planning of the trip, with
structured traveler consultations,
that can turn the traveler on auto-
nomous person that allow him to
become aware of his/her condition
of patient and of the severity, when
he/she should (or should not) start
therapies directed at the problem
and which therapies are best suited
to each condition. It is therefore
intended that, in a practical way, the
kit to approach the TD is as man-
datory as the passport, in order the
journey, dreamed and planned over
the years, is not conditioned or even
interrupted by the disease.
Of course, this kind of autonomi-
zation of the traveler, that implies
the autonomous taking of medi-
cation by laypeople, is not just an
individual matter. When it is at the
disposal all antibiotic therapies,
there is a probably contribution for
the increase of multidrug-resistant
bacterial strains, these individuals
will be carriers, with implications on
public health. Thus, it is fundamen-
tal that travelers are also alerted to
this problem, with the notion of the
risks and benefits of the antibiotics,
to have conscious and non-indiscri-
minate ingestion.
1. Riddle MS, Connor BA, Beeching NJ, DuPont
HL, Hamer DH, Kozarsky P, Libman
M, Emma R, Taylor D, Tribble DR, Villa
J, Singer P, Ericsson CD. Journal of Travel
Medicine, 2017, Vol 24, Suppl 1, S63–S80.
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