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Jim Marlowe's avatar

I tread lightly here because I greatly admire the author. Although I have always been a "fully vaccinated" traveler, I have re-assessed vaccines. Yet that is not why I comment.

On "Travelers' Diarrhea," even the CDC acknowledges that use of antibiotics shortens the course of sickness by 1-2 days. I'm pretty sure the CDC used to discourage antibiotic treatment for TD on the grounds that such use increases resistant strains. In any case, shortening TD by 1-2 days is quite a bit of time when one is traveling. https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/antibiotics-in-travelers-diarrhea

Here's what I have long questioned: The admonition that we should always take the full course of antibiotics to avoid encouraging antibiotic resistance. I am not an evolutionary biologist. I am just a lawyer. Yet the "full course" dogma has never made any sense to me. In fact, I would think the opposite is true. It is taking antibiotics for too long that may encourage resistance. The point is lightly discussed here:

https://theconversation.com/doctors-may-be-prescribing-antibiotics-for-longer-than-needed-112609

Inspiration for the reassessment of "full course" dogma came from here: https://www.bmj.com/content/358/bmj.j3418

Then back to another piece supposedly refuting it here:

https://theconversation.com/why-you-really-should-take-your-full-course-of-antibiotics-81704

But the "persisters" argument about lingering bugs still doesn't make sense to me.

In the end I remain highly skeptical that one must take the "full course" of antibiotics to avoid increasing resistant strains of antibiotics. How do the persisters magically gain resistance if they would have only been killed had they been exposed to the compound that didn't already kill them?

If the argument is that we would be better off with fewer bacteria in the world, and less antibiotics means more bacteria, that seems silly.

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Liz's avatar

I eat street food, but I have cast iron digestion from a very unsanitary childhood. My husband is usually more careful and wound up with amoebic dyssentery in Peru. The medical system that treated him was exceptional. Knowing oneself is important in this.

As for Las Vegas, it can be an adventure, just stay away from The Strip and the casinos. Incredible food and neighborhoods. I live about an hour away and I love adventuring there. Same for Los Angeles, I lived there 5 years and never went to Disneyland, but I went to Little Saigon, Monterrey Park, Korea Town, etc... So much adventuring to do there.

Tomorrow we are going to Querétaro and Friday we head up to the Sierra Gorda where people leave doors unlocked and I did not meet anyone who spoke English. There is an archeological park were locals walk their dogs. It has yet to be discovered except by locals who head up to escape the heat in summer. I had locally prepared food that was not "organic", they simply never stopped raising food the old ways.

I had a session with a local herbalist who about a half hour in told me how happy she was that I was not asking about hallucinogens. She said most Americans she talks to only want to get high. She told me about how no one in their community wore masks or got vaccinated and no one got very sick. They ate traditional food and took traditional herbs. Wonderful adventure.

I always eat indigenous food everywhere I go as it prevents illness. This was extra true in Lithuania where our Lithuanian friends were eating junk and got sick. We ate old school and were strong.

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