A Review of Guidelines/Guidance from Various Countries Around the World for the Prevention and Management of Travellers' Diarrhoea: A Pharmacist's Perspective.

International travel is growing and pharmacists are well placed to provide travel health services for the prevention and management of travellers' diarrhoea (TD). Legislation changes in many countries has enabled pharmacists to access prescription only medicines and vaccinations to provide advice and over the counter medicines for the prevention and management for travel health services; this makes sense since pharmacies are easily accessible to the public and are the patient's first port of call in the event of any illness. Currently, whilst many guidelines/guidance exist worldwide for the prevention and management of TD, there is no review that focuses on similarities and differences between these and between guidelines on TD and travel related and non-travel related acute diarrhoea. There is also a lack of publication on legislation and the need for evidence based training for all prescribers to provide travel health services. The aims of this work were to review guidelines/guidance for the prevention and management of TD from across the world which were compared with each other as were the TD guidelines compared to that for travel related and non-travel related acute diarrhoea for similarities and differences, with a focus on any relevant pharmacy legislation, needs assessments and training that may impact upon provision of travel health services by pharmacists focusing mainly on TD in adults. The PubMed, Google Scholar and Cochrane database were used to carry out an online search for publications on TD, acute diarrhoea and the guidance pharmacists have in the prevention and management of diarrhoea. The literature reviewed in this article indicates that where no specific guidelines/guidance existed, some pharmacists used the WHO guidelines (WHO), highlighting a need for local, regional and national evidence based guidelines in these countries.