Trial reportJournal of travel medicine2025
Efficacy of bismuth subsalicylate on the prevention of travellers' diarrhoea, 2018-2023.
Trial report in Journal of travel medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03535272 (Bismuth Subsalicylate's Role in the Prevention of Travelers' Diarrhea and Impact on Acquisition of Gut Antimicrobial Resistance Genes), which is not on this map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Bismuth Subsalicylate's Role in the Prevention of Travelers' Diarrhea and Impact on Acquisition of Gut Antimicrobial Resistance Genes
Who cites it
2 citing papers in PubMed.
- Author's response to concerns by Gibb, et al. on 'Efficacy of Bismuth Subsalicylate on the Prevention of Travelers' Diarrhea'.Journal of travel medicine · 2025Article
- Revisiting the efficacy of bismuth subsalicylate for the prevention of traveller's diarrhoea.Journal of travel medicine · 2025Article
Corrections and comments
- Commented on by
Authors and funding
14 authors.
Funding
Abstract
backgroundTravellers' diarrhoea (TD) is the most common travel-related illness. Bismuth subsalicylate (BSS) is indicated for the treatment of TD. BSS is also used off-label for the prevention of TD, based on studies from the 1980s indicating TD protection; however, these studies have limitations. The objective of this study was to determine the efficacy of BSS in the prevention of TD.
methodsThis study was a prospective, double-blinded, placebo-controlled, randomized clinical trial (NCT03535272) with two arms: BSS 4 tablets twice daily (2.1 grams of BSS total) vs placebo. Travellers were included if they were ≥ 18 and < 70 years of age at the time of enrollment, were leaving for an international trip ≥7 days after their pretravel consultation, travelling in country for ≥7 days but ≤ 21 days, and travelling to either Southeast Asia, South Central Asia, North Africa, or Sub-Saharan Africa. Self-completed web-based questionnaires were administered before, during, and after travel.
results270 participants were included. The median age was 32 years (Interquartile range [IQR]: 27-44); 63% were female. Travellers were most frequently White (144; 61%) and non-Hispanic (239; 94%). The most frequent country of travel was Kenya (n = 87; 32%). The median total trip duration was 10 days ([IQR]: 8-13). The most frequent reason for travel was leisure/tourism (230, 85%). There was no significant difference among the groups for symptoms of loose stool and/or diarrhoea, although target sample size was not reached.
conclusionsThis study provides the first new data since the 1980s about the potential use of BSS in the prevention of TD. These data should not be viewed as evidence in isolation because of sample size constraints; further studies are needed to determine if there is a benefit in certain traveller groups or under certain circumstances.
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Registered trials
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