{ "schema_version": 1, "kind": "condition", "id": "travellers-diarrhoea", "name": "Traveller's Diarrhoea", "category": "infectious", "sources": "CDC Yellow Book 2026: Travelers' Diarrhea (NCBI Bookshelf NBK620898), Treatment - Antibiotics; Table 1.6.1 · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (loperamide monograph) · WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 · WHO/UNICEF reduced-osmolarity oral rehydration salts (245 mOsm/L), recommended since 2002 · Rifaximin (XIFAXAN) DailyMed label, SetID f73acb74-e930-4414-81e9-d2a01db36e30, section 2.1", "review_status": "reviewed", "verified_against": "CDC Yellow Book 2026: Travelers' Diarrhea (NCBI Bookshelf NBK620898), Treatment - Antibiotics; Table 1.6.1 · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (loperamide monograph) · WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 · Traveller's Diarrhoea - disease-level clinical article (travellers-diarrhoea-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1747, "generic": "Azithromycin", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1000 mg single dose OR 500 mg once daily for 3 days", "adult_duration": "1-3 days", "dose_source": "CDC Yellow Book 2026: Travelers' Diarrhea (NCBI Bookshelf NBK620898), Treatment - Antibiotics; Table 1.6.1", "rationale": "Azithromycin is first-line in Egypt and South Asia due to widespread Campylobacter and ETEC fluoroquinolone resistance", "cautions": [ "Azithromycin is first-line for severe travellers diarrhoea or dysentery (fever/bloody stools).", "Fluoroquinolones (ciprofloxacin) are demoted in Egypt due to high resistance.", "Take with plenty of fluids." ], "peds_mgkg_low": 10.0, "peds_mgkg_high": 10.0, "peds_max_mg": 500.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "10 mg/kg once daily for 3 days (or 20 mg/kg single dose)", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 100, "high_mg": 100, "capped": false }, { "weight_kg": 20, "low_mg": 200, "high_mg": 200, "capped": false }, { "weight_kg": 30, "low_mg": 300, "high_mg": 300, "capped": false }, { "weight_kg": 40, "low_mg": 400, "high_mg": 400, "capped": false } ], "brands": [ { "trade_name": "AZATRIBACT 500MG 3 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RIVA PHARMA S.A.E.", "price_egp": 13.5, "pack_count": 3, "unit_price": 4.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GIGAZOCIN 500MG 5 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > PIONEER", "price_egp": 27.5, "pack_count": 5, "unit_price": 5.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SYSTYMYCIN 500MG 3 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > NOVELL PHARMA", "price_egp": 21.5, "pack_count": 3, "unit_price": 7.17, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZITHROMASH 500 MG 3 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 48.0, "pack_count": 3, "unit_price": 16.0, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZALIDE 500MG 3 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 52.0, "pack_count": 3, "unit_price": 17.33, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZROLID 500 MG 6 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 126.0, "pack_count": 6, "unit_price": 21.0, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZERAMERATE 500 MG", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > GAMMA PHARMA", "price_egp": 28.5, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DISTABCIN 500 MG 3 DISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI", "price_egp": 43.5, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHRODOSE 100MG/5ML SUSP. 15ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR > AVERROES PHARMA-EGYPT", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHROPHATE 200MG/5ML SUSP. 15ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANO PHARMA > NOVELL PHARMA", "price_egp": 12.75, "pack_count": null, "unit_price": null, "strength_mg": 200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "travellers-diarrhoea" }, { "id": 1750, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Traveller's Diarrhoea - disease-level clinical article (travellers-diarrhoea-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Avoid antimotility agents in patients with fever or bloody diarrhea." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "travellers-diarrhoea" }, { "id": 1751, "generic": "Rifaximin", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 200.0, "adult_dose": "One 200 mg tablet by mouth three times a day for 3 days, with or without food", "adult_duration": "3 days", "dose_source": "Rifaximin (XIFAXAN) DailyMed label, SetID f73acb74-e930-4414-81e9-d2a01db36e30, section 2.1 - verbatim: \"The recommended dose of XIFAXAN is one 200 mg tablet taken orally three times a day for 3 days.\"", "rationale": "The card already carries azithromycin, which is the right choice for severe or dysenteric illness. Rifaximin is the alternative for the common moderate, watery, non-febrile case: it stays in the gut, so it spares the patient systemic antibiotic exposure. It is registered in Egypt for exactly this indication and is affordable.", "cautions": [ "It is the wrong drug when there is fever or blood in the stool: the label states it was not effective in that setting, so treat those patients as invasive disease and use azithromycin.", "Stop it and reconsider the diagnosis if the diarrhoea worsens or has not improved within a day or two of starting.", "It does not work against Campylobacter, and its effect against Shigella and Salmonella is unproven - the pathogens to suspect after travel in Asia.", "Do not give it to anyone with a known hypersensitivity to rifaximin or to any rifamycin antibiotic.", "Avoid it in pregnancy: teratogenic effects were seen in animal studies and there are no human data.", "Rehydration remains the treatment; the antibiotic only shortens the illness." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not established below 12 years of age for travellers' diarrhoea; use the paediatric options listed instead.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "IDIBACT 200 MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG INDUSTRIES > NOVELL PHARMA", "price_egp": 34.0, "pack_count": 10, "unit_price": 3.4, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRENCEDIA 200 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 130.5, "pack_count": 30, "unit_price": 4.35, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BIOFAXIMIN 200 MG 30 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOPHARM EGYPT > SAJA PHARMACEUTICALS", "price_egp": 188.0, "pack_count": 30, "unit_price": 6.27, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRAVERIA 200 MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WESTERN PHARMACEUTICALS INDUSTRIES", "price_egp": 63.0, "pack_count": 10, "unit_price": 6.3, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FATROXIM 200 MG 30 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > ATM PHARMACEUTICAL INDUSTRIES", "price_egp": 243.0, "pack_count": 30, "unit_price": 8.1, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRAVIGUARD 200 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DBK PHARMA > TREND PHARM", "price_egp": 162.0, "pack_count": 20, "unit_price": 8.1, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NORMIX 200 MG 12 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFASIGMA > UNITED COMPANY FOR DISTRIBUTION", "price_egp": 134.5, "pack_count": 12, "unit_price": 11.21, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GASTROBIOTIC 200 MG 20 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ANDALOUS PHARMA", "price_egp": 243.0, "pack_count": 20, "unit_price": 12.15, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "travellers-diarrhoea" }, { "id": 1748, "generic": "Loperamide", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 2.0, "adult_dose": "4 mg initially, then 2 mg after each loose stool, max 16 mg daily", "adult_duration": "Max 2 days", "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (loperamide monograph)", "rationale": "Adjunct antimotility agent added to rehydration therapy that slows gut transit via opioid-receptor activity in the intestinal wall, reducing stool frequency; it does not treat the underlying infection and is avoided when there is bloody or febrile dysentery.", "cautions": [ "CONTRAINDICATED in dysentery (bloody stools/high fever) and bacterial colitis — risk of toxic megacolon.", "Do not use for more than 48 hours." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The Egyptian National Drug Formulary - Gastrointestinal Tract 2025 loperamide monograph contraindicates it in any child under 2 years, and confines its own indication to adults and to children of 12 years and above with acute diarrhoea. No dose below 12 years is stated there.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "MOTIJUST 2 MG 30 CAPS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG INDUSTRIES > NOVELL PHARMA", "price_egp": 27.0, "pack_count": 30, "unit_price": 0.9, "strength_mg": 2.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "STOPRRHEA 2 MG 10 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA", "price_egp": 10.0, "pack_count": null, "unit_price": null, "strength_mg": 2.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IMODIUM INSTANT 2MG 6 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MCNEIL PRODUCTS LTD. > JOHNSON & JOHNSON SCIENTIFIC OFFICE", "price_egp": 80.0, "pack_count": null, "unit_price": null, "strength_mg": 2.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "STOPRRHEA 2 MG 30 ORODISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA", "price_egp": 96.0, "pack_count": null, "unit_price": null, "strength_mg": 2.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "travellers-diarrhoea" }, { "id": 1749, "generic": "ORS", "line": 1, "is_adjunct": true, "form": "oral.liquid", "strength_mg": null, "adult_dose": "Drink fluid/ORS solution after each loose stool", "adult_duration": "As needed", "dose_source": "WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005", "rationale": "Adjunct oral rehydration solution added alongside antimicrobial and antimotility therapy to replace the fluid and electrolyte losses of traveller's diarrhoea; it does not treat the underlying infection but is essential supportive care regardless of cause.", "cautions": [ "Use the reduced-osmolarity formulation (sodium 75, glucose 75, potassium 20, citrate 10, chloride 65 mmol/L; 245 mOsm/L). WHO replaced the older 311 mOsm/L formula in 2002 for diarrhoea of any cause at any age - it cuts stool output and vomiting.", "ORS is essential baseline therapy to prevent dehydration." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Encourage fluid replacement after every stool", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "GLUCOHYDRAN 10 SACHET.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 1.75, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "REHYDRAN N 10 SACHET", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "REHYDRO ZINC 10 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 7.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ORS 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 40.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ELECTRO MASH SYRUP 200 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 60.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLEXOLYTE ORAL REHYDRATION SOL. 240 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KEMPETRO FOR CHEMICAL INDUSTRIES", "price_egp": 65.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HERO ORS 200 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HERO > HERO MEA TRADING", "price_egp": 120.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SANSO ORS SYRUP 140 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 400.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "travellers-diarrhoea" } ] }