Antibiotics in Suspected Infectious Diarrhea

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