Travel Medicine is a rapidly evolving field of medicine that is becoming ever more important in this era of globalization. Traditionally, medical preparation for individuals traveling to countries outside the United States has focused on traveler's
diarrhea prevention and treatment,
malaria prevention, and travel vaccination. Now, other concerns such as travel safety must also be considered. New developments in the area of travel medicine include the use of
azithromycin instead of
quinolones for
diarrhea acquired in Southeast Asia.
Azithromycin may also be the best option for children and patients who cannot take
quinolones regardless of destination. In addition,
rifaximin, a non-absorbable
antibiotic, has recently been marketed for traveler's
diarrhea. The best
malaria prophylaxis options currently include
atovaquone-proguanil (
Malarone) in addition to
chloroquine,
mefloquine, and
doxycycline.
Hepatitis A is the most important travel
vaccine, and a new combined
hepatitis A and B
vaccine (
Twinrix) is useful for travelers needing protection against both types of
hepatitis. A
vaccine for
typhoid is now available in either oral or
injectable versions. Other important
vaccines to consider when traveling internationally are those for
Japanese encephalitis,
influenza,
meningitis,
rabies,
varicella and
yellow fever vaccines. These may be warranted depending on duration of travel and destination risk.