Traveler's diarrhea: Difference between revisions
| Line 25: | Line 25: | ||
**[[Ofloxacin]] 300mg PO BID x 3 days OR | **[[Ofloxacin]] 300mg PO BID x 3 days OR | ||
**[[Rifaximin]] 200mg PO TID x 3 days OR | **[[Rifaximin]] 200mg PO TID x 3 days OR | ||
**[[ | **[[Azithromycin]] 1000mg PO x 1 OR 500mg PO q24h x 3 days | ||
*Antimotility agent | *Antimotility agent | ||
**Only for nonpregnant adults with no fever or blood in stool | **Only for nonpregnant adults with no fever or blood in stool | ||
Revision as of 03:19, 26 June 2014
Background
- Most respond to antibiotics
- as duration of diarrhea increases, higher chance of parasitic cause
DDx
- See DDx Diarrhea
- Giardia
- Cryptosporidiosis
- Entamoeba
- Cyclospora
Diagnosis
- dysentery if stool bloody, fvr or wbc in stool- invasive inflamm enteropathy
- has abrupt onset, metastatic lesions, reactive arthopathies, or campylobacter assoc guillain barre- maybe flouroquinolone resis esp in SE Asia
- amoebic dysentery insidious and can get amoebic liver abscess
- if do not find infc cause of dysentery, eval pt for IBD or CA
- prolonged diarrhea and malabsorption- giardia or tropical sprue- does not respond to removal of gluten from diet- tx with tetra and folate
- also consider postinfectious disaccharidase deficiency or irritable bowel dz
- if diarrhea starts >1 mo after travel- not caused by travel
Treatment[1]
- Antibiotic
- Ciprofloxacin 750mg PO BID x 1-3 days OR
- Levofloxacin 500mg PO q24h x 1-3 days OR
- Ofloxacin 300mg PO BID x 3 days OR
- Rifaximin 200mg PO TID x 3 days OR
- Azithromycin 1000mg PO x 1 OR 500mg PO q24h x 3 days
- Antimotility agent
- Only for nonpregnant adults with no fever or blood in stool
- Loperamide 4mg PO after each loose stool (Max: 16mg/day)
Pediatrics[2]
- Azithromycin 10mg/kg/day once daily x 3 days OR
- Ceftriaxone 50mg/kg/day once daily x 3 days
- Avoid fluroquinolones