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Mil Med. 2017 Sep;182(S2):1-3. doi: 10.7205/MILMED-D-17-00066.

Preface: Guidelines for the Treatment of Travelers' Diarrhea in Deployed Military Personnel.

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Enteric Disease Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910.
Infectious Disease Clinical Research Program, Preventive Medicine and Biostatistics Department, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.


Diarrheal disease frequently affects military personnel deployed to developing countries, resulting in decreased job performance and potential negative impacts on military operational readiness. Travelers' diarrhea is a self-limiting illness; however, antibiotic treatment (with and without use of adjunct loperamide therapy) has been shown to significantly reduce clinical presentation of symptoms and duration of illness. Nonetheless, the choice of first-line antibiotics must be carefully considered as increasing resistance of enteric pathogens in endemic regions has rendered many first-line antibiotics ineffective (e.g., Campylobacter spp. are resistant to fluoroquinolones in Southeast Asia). Presently, there are no standardized recommendations for the treatment of travelers' diarrhea among deployed military personnel. Therefore, an expert panel was convened to develop evidence-based, consensus-driven guidelines that address key clinical issues related to self-treatment, antibiotic treatment for acute watery diarrhea and febrile diarrhea/dysentery, and diagnostics. These guidelines "Management of Acute Diarrheal Illness during Deployment" are published in this supplement along with articles reviewing the evidence-based data that supported their development.

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