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.
King, John G. MD, MPH, "Antibiotics in Suspected Infectious Diarrhea" (2012). Family Medicine Scholarly Works. 5.
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