Antimicrobial drugs in Diarrhoea

Question 1

It is advisable not to use these except

Answer 1

where the following specific organisms are identified.

Use appropriate reduced doses for children.

Question 2

Shigella dysentery (moderate to severe)

Answer 2

Cotrimoxazole (DS) 1 tab (o) 12 hrly for 5 d

or

Norfloxacin 400 mg (o) 12 hrly for 5 d or ciprofloxacin

Question 3

Campylobacter jejuni (if prolonged)

Answer 3

Norfloxacin 400 mg (o) 12 hrly for 5 d

or

Azithromycin 500 mg (o) daily for 3 d

Question 4

Salmonella enteritis

Answer 4

It is a notifiable disease

Antibiotics are not generally advisable

• but if severe or prolonged use:

Ciprofloxacin 500 mg (o) bd

or

Azithromycin for 7 days.

Question 5

Giardiasis

Answer 5

Tinidazole 2 g (o), single dose (may need to be repeated)

or

Metronidazole 2 g (o) daily for 3 d

Question 6

Amoebiasis (intestinal)

Answer 6

Specialist advice should be sought.

Metronidazole 600 mg (o) tds for 7–10 d or tinidazole

plus

Diloxanide furonate 500 mg (o) tds for 10 d (to prevent relapse)

Question 7

Typhoid/paratyphoid fever

Answer 7

Azithromycin 1 g (o) or IV

• until oral can be tolerated per d for 7 d
• or (if not acquired in Indian subcontinent)

Ciprofloxacin 500 mg (o) 12 hrly for 7–10 d

Question 8

Cholera

Answer 8

Antibiotic therapy reduces the volume and duration of diarrhoea

• but rehydration is the key factor.

Azithromycin 1 g (child 20 mg/kg) (o) as single dose

or

Ciprofloxacin 1 g (child 25 mg/kg up to 1 g) (o) as single dose

Question 9

Pseudomembranous colitis

Answer 9

Cease antibiotic

Choice 1: metronidazole 400 mg (o) tds for 7–10 d

or

Choice 2: vancomycin 125 mg (o) qid for 10 d