Management of infectious diarrhoea

Not all episodes of infectious diarrhoea need treating with antibiotics, and often, resistance to certain antibiotics (e.g. ciprofloxacin) leads to sub-optimal treatment.

Any patient who has been in hospital recently is at risk of C. difficile infection - especially if they may have had antibiotics. This needs to be actively tested for and treated appropriately (metronidazole as first-line treatment, then oral vancomycin). Hence, it is imperative in managing patients with diarrhoea to ensure adequate and suitable stool samples are sent early in the illness. Colonic imaging is usually not indicated in infective colitis (other than a simple X-ray to exclude toxic megacolon) and is only necessary if symptoms persist and stool cultures are negative.

Fig 1: Clostridium Difficile Diarrhoea

Source: Fig 1