Sandbox/diarrhea

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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

Enteropathogenic E.coli species

  ▸  Adults

  ▸  Children

Enteroinvasive E.coli species

  ▸  Adults

  ▸  Children

Enteroaggregative E.coli species

  ▸  Adults

  ▸  Children

Enterohemorrhagic E.coli species

  ▸  Adults

  ▸  Children

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
Erythromycin 500 mg orally q12h X 5 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
Erythromycin 500 mg orally q12h X 5 days
Immunocompromised patients
Preferred Regimen
Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 5-7 days

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.