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Evidence Review



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Clinical Question: When should antibiotics be given for suspected infectious diarrhea?

Bottom line answer: Antibiotics has been shown to be beneficial in the following groups based on randomized clinical trials (SORT A):

  • Moderate to severe traveler’s diarrhea (more than four unformed stools, fever, blood, pus or mucus in the stool).
  • More than eight stools per day, dehydration, symptoms of more than one week, and those in which hospitalization is considered.
  • Avoid antibiotics in some infections (bloody diarrhea and abdominal pain, but little or no fever – consistent with possible STEC infection). Empiric treatment:
  • Oral fluoroquinolone (ciprofloxacin, oflaxacin, levofloxicin) for 3-5 days OR
  • Azithromycin, erythromycin.

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Creative Commons Attribution-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-No Derivative Works 3.0 License.

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