Probiotics and Antibiotics Use for the Prevention of Travelers’ Diarrhea Among Polish Tourists—Results from an Online Survey: Why Is Education Needed?

TL;DR

A survey of Polish tourists found that many use probiotics and some use antibiotics to prevent traveler's diarrhea, highlighting the need for better public education on these practices.

Contribution

First study to assess probiotic and antibiotic use for TD prevention among Polish travelers, revealing self-medication trends and gaps in medical guidance.

Findings

24% of Polish travelers reported using probiotics for TD prevention, with higher use among frequent travelers and younger females.

5.3% of respondents used antibiotics as TD prophylaxis, more common among those without comorbidities.

Only 10.9% of probiotic users received medical recommendations, indicating widespread self-medication.

Abstract

Background/Objectives: Traveler’s diarrhea (TD) is a pressing issue, affecting a significant portion of international travelers. Despite the guidelines discouraging routine use of antibiotics and the inconclusive evidence supporting probiotics for TD prevention, both remain popular prophylactic strategies. However, data on these practices among Polish tourists are currently lacking. The objective of this study was to assess the prevalence of probiotic and antibiotic use as preventive measures against TD among Polish travelers. Methods: A cross-sectional survey was conducted between July and August 2025 among adults with at least one international trip per year. An anonymous online questionnaire collected demographic data, travel frequency, and the use of probiotics and/or antibiotics for TD prophylaxis. Results: Of 873 respondents, 848 completed the questionnaire (median age: 35 years; 62.5% female). Probiotic use for TD prevention was reported by 24% of respondents (7.4% during all travels, 11.9% during trips outside of Europe, and 4.7% occasionally). Probiotic use was significantly associated with higher travel frequency, female sex, and younger age. Antibiotic use for TD prophylaxis was declared by 5.3% of participants, more common among those without comorbidities, with no significant association with age, sex, or travel frequency. Additionally, 21.6% of respondents reported regular, daily use of probiotics, though only 10.9% were recommended by physicians. Conclusions: This study’s findings reveal that a significant proportion of Polish travelers used probiotics for TD prevention, despite limited evidence and expert guidelines. A small subset of respondents used an antibiotic as TD prophylaxis. As global antibiotic resistance continues to rise, emphasizing antimicrobial stewardship in travel medicine practice is crucial. The fact that many individuals self-administer probiotics without medical consultation underscores the need for greater public education on the risks, benefits, and limitations of these interventions.