Acute Infectious Diarrhea Flashcards
Diagnostic evaluation using stool culture and culture-independent methods if available should be used in situations where the individual patient is at high risk of spreading disease to others, and during known or suspected outbreaks.
strong, low evidence
Stool diagnostic studies may be used if available in cases of dysentery, moderate-severe disease, and symptoms lasting > 7 days to clarify the etiology of the patient’s illness and enable specific directed therapy.
strong, low evidence
Antibiotic sensitivity testing for management of the individual w/ acute diarrheal infection is currently not recommended.
strong, low evidence
The usage of balanced electrolyte rehydration over other oral rehydration options in the elderly w/ severe diarrhea or any traveler w/ cholera-like watery diarrhea is recommended.
strong, moderate evidence
The use of probiotics or prebiotics for the treatment of acute diarrhea in adults is not recommended, except in cases of postantibiotic-associated illness.
strong, moderate evidence
Bismuth can be administered to control rates of passage of stool and may help travelers function better during bouts of mild-to-moderate illness.
strong, high evidence
In patient receiving antibiotics for traveler’s diarrhea, adjunctive loperamide therapy should be administered to decrease duration of diarrhea and increase chance for a cure.
strong, moderate evidence
The evidence does not support empiric anti-microbial therapy for routine acute diarrheal infection, except in cases of TD where the likelihood of bacterial pathogens is high enough to justify the potential side effects.
strong, high evidence
Use of antibiotics for community-acquired diarrhea should be discouraged as epidemiological studies suggest that most community-acquired diarrhea is viral in origin and is not shortened by the use of antibiotics.
strong, low evidence
Serological and clinical lab testing in individuals w/ persistent diarrheal symptoms (between 14 and 30 days) are not recommended.
strong, low evidence
Endoscopic evaluation is not recommended in individuals w/ persisting symptoms (between 14 and 30 days) and negative stool work-up.
strong, low evidence
Frequent and effective hand washing and alcohol-based hand sanitizers are of limited value in preventing most forms of traveler’s diarrhea but may be useful where low-dose pathogens are responsible for the illness as for an example during a cruise ship outbreak of norovirus infection, institutional outbreak, or in endemic diarrhea prevention.
conditional, low evidence
Bismuth has moderate effectiveness as prophylaxis and may be considered for travelers who do not have contraindications to use and can adhere to the frequent dosing requirements.
strong, high evidence
Probiotics, prebiotics, and synbiotics for the prevention of TD are not recommended.
conditional, low evidence
Antibiotic chemoprophylaxis has moderate to good effectiveness and may be considered in high-risk groups for short-term use.
strong, high evidence
