Which antibiotic class should be avoided in acute diarrhea acquired by a traveler to southeast Asia?
Quinolone resistance is prevalent among Campylobacter strains found in southeast Asia and increasingly elsewhere, with rising incidence in Russia, India, and some eastern European countries. The high rate of resistance to this antibiotic class makes them a poor choice for the empiric treatment of traveler’s diarrhea in these locations. Azithromycin is currently the agent of choice for empiric treatment of traveler’s diarrhea in areas where Campylobacter infection is likely to be resistant . Campylobacter is also among the more common causes of dysentery, and avoidance of quinolones to treat such clinical presentations is reasonable regardless of geographic location.