Travelers' diarrhea: Clinical practice guidelines for pharmacists

Public Health Importance of Emporiatrics: A Review

People travel all around the world to explore, trade, sojourn, etc. Millions of individuals cross national and international borders. Travel medicine services are offered by general practitioners, specialized travel clinics, or immunization centers. Epidemiology, illness prevention, and travel-related self-treatment are all included in the interdisciplinary field of travel medicine. The main objective is to keep travelers alive and in good health, by reducing the effects of illness and accidents through preventative measures and self-care. The danger to a traveler's health and well-being must be understood, and the travel medicine practitioner's job is to help their patient or client recognize and manage those risks. The absence of any disease or symptom does not always indicate good health. Chronic illness sufferers, including those with cancer, diabetes, and hypertension, can maintain a reasonable level of health and mobility. Travel medicine is a rapidly developing, extremely dynamic, multidisciplinary field that calls for knowledge of a range of travel-related illnesses as well as current information on the global epidemiology of infectious and non-infectious health risks, immunization laws and requirements around the world, and the shifting trends in drug-resistant infections. Pre-travel consultation aims to reduce the traveler's risk of disease and harm while on the road through preventive counseling, education, recommended drugs, and essential vaccines. Specialized medical guidance can help reduce the potential health risks of travel. Emporiatrics is not only used for traveling advice or things to be done during the period of the journey but it also creates room in implementing the interdisciplinary subject with new methods or development of new policies, technologies, and various programs to reduce unnecessary problems of the travelers, which will boost tourism.

Global travel and Gram-negative bacterial resistance; implications on clinical management

INTRODUCTION

Antimicrobial resistance (AR) is escalating worldwide with the potential for dire consequences, global travel contributes to the dissemination of resistant pathogens from one region to another. The World Health Organization identified the rapid emergence and prevalence of carbapenem-resistant Gram-negative species, including Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa, as an international crisis due to treatment challenges, poor health outcomes, increased mortality, and high economic costs caused by these pathogens.

AREAS COVERED

This review describes key carbapenem-resistant (CR) Gram-negative species, changes in current global and regional trends, AR surveillance and reporting, and identifies drivers of change, specifically travel. Finally, we review clinical implications and challenges of treating CR infections which exist due to widespread dissemination of CR bacteria. A literature search was conducted using PubMed, Google Scholar, Ebsco, and ProQuest (from 2000 to December 2019).

EXPERT OPINION

The level of global travel is increasing, and antimicrobial resistance continues to disseminate worldwide. Healthcare providers risk assessment for AR needs to consider a patient's recent travel history, including pre-travel and intra-travel antimicrobial prescription, and potential exposure based on geography. Patient education, healthcare provider awareness, and access to data and surveillance resources are critical to inform antimicrobial selection and improve health outcomes.