Second on the usefullness of azithromycin in travel medicine situations. On a couple of trips to India, azithromycin seemed useful in those worrisome cases of diarrhea accompanied by a little fever and aches that were concerning for a bacterial etiology. Ditto for coughy URI types of things. With limited access to diagnostics, perhaps these syndromes were viral/self-limited, but people were on vacation and pushing themselves and trying not to get sidelined by an infection. Azithromycin seemed to do no harm.
Of course, we should minimize antibiotic use whenever possible. As a medical person involved in antibiotic use I appreciate learning about these real-life experiences from the TAY community. I like the hypothesis about complex mixed causality: a cartilage-weakening drug effect "plus" the mechanical stresses of an active lifestyle.
