Ciprofloxacin no longer recommended for travellers’ diarrhoea

Ciprofloxacin medicine pack
Dr Fox no longer supplies ciprofloxacin for travellers’ diarrhoea

February 2019: Public Health England’s antimicrobial prescribing guidance no longer recommends fluoroquinolones (ciprofloxacin) for standby treatment of travellers’ diarrhoea, due to increasing resistance to these antibiotics in some parts of the world.

National Institute of Health and Care Excellence (NICE) and Public Health England recommends standby azithromycin for patients at high risk of severe illness should they develop travellers’ diarrhoea or those visiting high-risk areas.

As a result Dr Fox has withdrawn supply of ciprofloxacin for travellers’ diarrhoea, and provides the recommended alternative azithromycin only.

Read in full

Is Malarone from ASDA the cheapest option?

ASDA storeASDA is now (September 2018) not the cheapest option to buy Malarone anti-malaria tablets, and it may not be the most convenient option for many people either.

ASDA sell Malarone tablets for £1.25 each and provide the choice of branded GSK Malarone or non-branded generic Malarone (atovaquone/proguanil). Both are medically identical and equally effective (no anti-malaria tablet is 100% effective).

How to buy from ASDA

To buy Malarone from ASDA you will need to:

  1. Find a local branch with an in-store pharmacy.
  2. Book an appointment with the pharmacist at the ASDA store (for each person requiring tablets).
  3. At the appointment complete a medical questionnaire (10-15 mins).
  4. The pharmacist will assess your information and dispense the appropriate tablets.

Order online with fast delivery

Dr Fox provides a convenient mail order option for £1.09 per tablet (plus small prescription fee and P&P). Read in full

Preventing Malaria – five simple steps for travellers

photo of malarial mosquitoAs we’ve seen in recent news, travelling to a country where disease-carrying mosquitos thrive can have lasting repercussions. The Aedes mosquito is responsible for the transmission of viruses like Dengue, Chikungunya, and Zika. Malaria, on the other hand, is transmitted by the Anopheles mosquito, and it isn’t a virus.

Malaria is a caused by the Plasmodium parasite, which is picked up from infected people by female mosquitos. When the mosquito bites again, it transmits the parasite, now mixed with the mosquito’s saliva, to the blood of its victim.

There are four types of human malaria, of which the deadliest is Falciparum malaria, which is responsible for close to one million deaths in Sub-Saharan Africa every year.

Malaria symptoms usually come on one to two weeks after being bitten, and are flu-like in nature. They include fever, chills, vomiting and headaches. If the person does not receive proper treatment the parasite can be deadly, killing the host by destroying red blood cells and obstructing the arteries. Read in full

How to get a good night’s sleep

sleep-wellAre you one of the many people who fall asleep easily, only to wake up a few hours later and struggle to get back to sleep again? According to a 2013 report by, almost half of Brits are kept awake by stress or worry at night. Perhaps you have trouble falling asleep in the first place, or find yourself waking throughout the night. Millions of people suffer from some form of insomnia, but sleep can be improved by practicing better sleeping habits and pinpointing what it is that keeps you up at night.

Addressing your so-called ‘sleep hygiene’ (a term used by the NHS) can help you determine what you can do differently to get more sleep, before turning to sleeping pills or tonics. Read in full

Posted on in Jet lag

Getting rid of the runs: treating travellers’ diarrhoea

travellers diarrhoea preventionDiarrhoea is commonly caused by a bowel infection due to a virus, bacteria or parasite. Increased exposure to gastroenteritis-causing factors is why diarrhoea is so common amongst travellers; in fact up to five million Brits suffer from it every year.

It normally begins during the first week after arriving in a new place; trying new foods exposes us to new bacteria that our bodies are not used to. It also puts us at risk of dangerous bacteria such as salmonella and E. Coli, as well as parasites like Giardia and viruses like the norovirus. All of these are transmitted through hand to mouth contact, and eating or drinking contaminated food or water. Diarrhoea can also be caused by eating different foods with higher levels of spice or oil than our normal diet.

If all this has put you off eating or drinking anything in a new country (or even travelling at all!), try to keep in mind that there are things you can do to decrease the severity and length of a diarrhoea episode abroad. Read in full

Simple ways to prevent jet lag

prevent jet lagFrequent travelers are all too familiar with the feeling of jet lag; the extreme fatigue, insomnia at night, digestion problems and trouble concentrating on simple tasks. Whether you are a first time flyer, or about to embark on your first long haul flight, jet lag and its effects on your body can come as a bit of a shock.

With the introduction of cheaper flights and the newly increased popularity of travelling to areas of Eastern Asia, such as Thailand, more and more Brits are embarking on long distance holidays.

Whilst there is no way to fully prevent the effects of jet lag, there are many simple approaches to long distance travelling which can help relieve the symptoms and make your journey more pleasant. Read in full

Daily Mail: The effect of vomiting and diarrhoea on medication

vomiting diarrhoea effect oral medicinesDr Steele, the Medical Director of the Dr Fox website, was quoted in an article in the Daily Mail published on 26th May 2014. The article, written by journalist Joani Walsh, was titled ‘On medication? A minor tummy upset can put you in peril: From heart pills to anti-stroke drugs, a bout of sickness may wipe out all your protection‘.

The article deals with the risks of vomiting whilst taking long-term medication and focused on the case of a Nurse, Victoria Ord, who contracted Malaria on a visit to Gambia. Vomiting of her malaria tablets left Victoria vulnerable to a serious malaria infection.

The Daily Mail article quotes Dr Steele as saying:

People think that once a pill is swallowed, the effect is immediate. Vomiting or diarrhoea can effectively mean a missed dose and it can be critical – enough to throw some patients on medication for heart problems into heart failure.

Whether missing one or more of your tablets because of vomiting will lead to serious health problems depends on which tablets and why they are being taken. People taking long term medication who plan to travel for prolonged periods in remote areas should talk to their doctors before they leave. Read in full

New pill that puts an end to jet lag

new jet lag pillMost of us have been on a long-haul flight and suffered the disconcerting and exhausting effects of jet lag – but a new pill could now make it a thing of the past.

Researchers at Manchester University have discovered an enzyme – CK1epsilon – that resets our body clock and keeps our body operating on a normal 24 hour rhythm. When the enzyme is suppressed the rhythm resets itself, making it easier to stay awake at night and sleep during the daytime.

Team leader Dr David Bechtold said that modern life poses a raft of potential health challenges and disruptions to the normal patterns of our body clocks, including sleep deprivation, shift work and jet lag. Major disruptions in the natural body clock can increase the risk of strokes and heart attacks by up to 40%. Read in full