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<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
<font color="#FFF">
'''Enterotoxigenic E.coli species'''
</font>
</div>
<div class="mw-customtoggle-table51" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Adults'''
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<div class="mw-customtoggle-table52" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Children'''
</font>
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<div style="border-radius: 0 0 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
<div style="border-radius: 0 0 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
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<div class="mw-customtoggle-table52" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<div class="mw-customtoggle-table72" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Enterotoxigenic '''
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Enterotoxigenic '''
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|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Erythromycin]] 500 mg orally q12h X extended period'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Erythromycin]] 500 mg orally q12h X extended period'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table51" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Immunocompetent patients}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Trimethoprim-sulfamethoxazole]]  160/800 mg orally q12h X 3 days'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ofloxacin]] 300 mg orally q12h X 3 days'''''<BR> OR <BR> ▸ '''''[[Norfloxacin]] 400 mg orally q12h X 3 days'''''<BR> OR <BR> ▸ '''''[[Ciprofloxacin]] 500 mg orally q12h X 3 days'''''
|-
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Immunocompromised patients}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Trimethoprim-sulfamethoxazole]]  160/800 mg orally q12h X 5-7 days'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ofloxacin]] 300 mg orally q12h X 5-7 days'''''<BR> OR <BR> ▸ '''''[[Norfloxacin]] 400 mg orally q12h X 5-7 days'''''<BR> OR <BR> ▸ '''''[[Ciprofloxacin]] 500 mg orally q12h X 5-7 days'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table52" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Immunocompetent patients}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Trimethoprim-sulfamethoxazole]]  5/25 mg orally q12h X 3 days'''''
|-
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Immunocompromised patients}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Trimethoprim-sulfamethoxazole]]  5/25 mg orally q12h X 5-7 days'''''
|-
|-
|}
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{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table52" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table72" style="background: #FFFFFF;"
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{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"

Revision as of 00:04, 2 June 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mugilan Poongkunran M.B.B.S [2]

Antibiotic Therapy

Pathogen Specific

▸ Click on the following categories to expand treatment regimens.[1][2]

Shigella species

  ▸  Adults

  ▸  Children

Non-typhi species of Salmonella

  ▸  Adults

  ▸  Children

Campylobacter species

  ▸  Adults

  ▸  Children

Enterotoxigenic E.coli species

  ▸  Adults

  ▸  Children

Escherichia coli species

  ▸  Enterotoxigenic

  ▸  Enteropathogenic

  ▸  Enteroinvasive

  ▸  Enteroaggregative

  ▸  Enterohemorrhagic (STEC)

Aeromonas / Plesiomonas

  ▸  Adults

  ▸  Children

Yersinia species

  ▸  Adults

  ▸  Children

Vibrio cholerae O1 or O139

  ▸  Adults

  ▸  Children

Toxigenic Clostridium difficile

  ▸  Adults

  ▸  Children

Parasites

  ▸  Giardia

  ▸  Cryptosporidium species

  ▸  Isospora species

  ▸  Cyclospora species

  ▸  Microsporidium species

  ▸  Entamoeba histolytica

Immunocompetent patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 3 days
Alternative Regimen
Ofloxacin 300 mg orally q12h X 3 days
OR
Norfloxacin 400 mg orally q12h X 3 days
OR
Ciprofloxacin 500 mg orally q12h X 3 days
OR
Nalidixic acid 1g orally q24h X 5 days
OR
Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 3 days
OR
Azithromycin X 3 days
Immunocompromised patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 7-10 days
Alternative Regimen
Ofloxacin 300 mg orally q12h X 7-10 days
OR
Norfloxacin 400 mg orally q12h X 7-10 days
OR
Ciprofloxacin 500 mg orally q12h X 7-10 days
OR
Nalidixic acid 1g orally q24h X 7-10 days
OR
Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 7-10 days
OR
Azithromycin X 7-10 days
Immunocompetent patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 5/25 mg/kg orally q12h X 3 days
Alternative Regimen
Nalidixic acid 55 mg/kg/day X 5 days
OR
Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 3 days
OR
Azithromycin X 3 days
Immunocompromised patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 5/25 mg/kg orally q12h X 7-10 days
Alternative Regimen
Nalidixic acid 55 mg/kg/day X 7-10 days
OR
Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 7-10 days
OR
Azithromycin X 7-10 days
Immunocompetent
Preferred Regimen
Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 5-7 days
Alternative Regimen
Ofloxacin 300 mg orally q12h X 5-7 days
OR
Norfloxacin 400 mg orally q12h X 5-7 days
OR
Ciprofloxacin 500 mg orally q12h X 5-7 days
OR
Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 5-7 days
Immunocompromised patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 14 days
Alternative Regimen
Ofloxacin 300 mg orally q12h X 14 days
OR
Norfloxacin 400 mg orally q12h X 14 days
OR
Ciprofloxacin 500 mg orally q12h X 14 days
OR
Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 14 days
Immunocompetent
Preferred Regimen
Trimethoprim-sulfamethoxazole 5/25 mg/kg orally q12h X 5-7 days
Alternative Regimen
Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 5-7 days
Immunocompromised patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 5/25 mg/kg orally q12h X 14 days
Alternative Regimen
Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 14 days
Immunocompetent
Preferred Regimen
Erythromycin 500 mg orally q12h X 5 days
Immunocompromised
Erythromycin 500 mg orally q12h X extended period
Immunocompetent
Preferred Regimen
Erythromycin 500 mg orally q12h X 5 days
Immunocompromised
Erythromycin 500 mg orally q12h X extended period
Immunocompetent patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 3 days
Alternative Regimen
Ofloxacin 300 mg orally q12h X 3 days
OR
Norfloxacin 400 mg orally q12h X 3 days
OR
Ciprofloxacin 500 mg orally q12h X 3 days
Immunocompromised patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 5-7 days
Alternative Regimen
Ofloxacin 300 mg orally q12h X 5-7 days
OR
Norfloxacin 400 mg orally q12h X 5-7 days
OR
Ciprofloxacin 500 mg orally q12h X 5-7 days
Immunocompetent patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 3 days
Immunocompromised patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 5-7 days
Immunocompetent patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 3 days
Alternative Regimen
Ofloxacin 300 mg orally q12h X 3 days
High risk bites (deep bites, symptomatic animals
Preferred Regimen (without CNS symptoms)
Acyclovir 12.5–15 mg per kg IV q8h
OR
Ganciclovir 5 mg per kg IV q12h
Preferred Regimen (with CNS symptoms)
Ganciclovir 5 mg per kg IV q12h
Uncomplicated
Preferred Regimen
Amoxicillin-clavulanate 875/125 mg orally q12h
Alternative Regimen (beta-lactam allergy)
Doxycycline 100 mg orally q12h
Rat bite fever
Preferred Regimen
Penicillin G benzathine 600,000 to 1,000,000 units/day IM X 10-14 days
Alternative Regimen
Streptomycin 15 mg/kg/day IM in a single dose or in 2 divided doses X 10-14 days
Early (not yet infected)
Preferred Regimen
Amoxicillin-clavulanate 45 mg/kg/day orally in two divided doses X 3-7 days
Alternative Regimen
Cefuroxime 10 to 15 mg/kg orally q12h
Rat bite fever
Preferred Regimen
Penicillin G benzathine 25,000 to 50,000 units/day IM X 10-14 days
Alternative Regimen
Streptomycin 15 mg/kg/day IM in a single dose or in 2 divided doses X 10-14 days
Immunocompetent patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 3 days
Pig (Swine)
Preferred Regimen
Amoxicillin-clavulanate 875/125 mg orally q12h X 5 days
Alternative Regimen
Ampicillin sulbactam
Suspected Leptospirosis
Preferred Regimen

References

  1. Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV; et al. (2001). "Practice guidelines for the management of infectious diarrhea". Clin Infect Dis. 32 (3): 331–51. doi:10.1086/318514. PMID 11170940.
  2. Cohen SH, Gerding DN, Johnson S, Kelly CP, Loo VG, McDonald LC; et al. (2010). "Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA)". Infect Control Hosp Epidemiol. 31 (5): 431–55. doi:10.1086/651706. PMID 20307191.