Traveler’s Diarrhea occurs in 30-70% of travelers to countries with poor or unhygienic sanitary systems and limited access to safe drinking water.  The illness is self-limited and typically resolves within a few days.  Treatment with Bismuth Subsalicylate (pepto-bismol) is the preferred agent, if needed, along with fluid restoration and Pedialyte preparations to restore electrolytes.  High doses of Bismuth Subsalicylate may result in salicylate toxicity.  Avoid Bismuth Subsalicylate in children (Reye’s Syndrome), pregnant women, and caution with those already taking aspirin.  If fever occurs and non-bloody stools, or if diarrhea or abdominal pain is moderate to severe, a one-time dose of 1 gram of azithromycin can be considered.  If bloody stools occur without fever, consider withholding antibiotics as, if the pathogen is the Shiga toxin-producing E. coli(O157:H7), there may be increased risk for Hemolytic Uremic Syndrome.