Infectious diarrhea: pocket synopsis for diagnosis and management

  • Hamilton KW & al.
  • JAMA
  • 14 Feb 2019

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

Why this matters

  • Infectious diarrhea hits almost 200 million people each year in the United States.
  • Although most patients do not require anything but supportive care, some need antimicrobial therapies. 

Key highlights

  • Guidelines target children and adults with suspected or confirmed infectious diarrhea.
  • With fever, blood/mucoid stools, severe abdominal pain, sepsis: test stool for SalmonellaShigellaCampylobacterYersiniaClostridium difficile, and Shiga toxin–producing Escherichia coli.
  • Testing not recommended for uncomplicated traveler’s diarrhea
  • With bloody diarrhea and no sepsis, antibiotics should be avoided in most immunocompetent patients.
  • Probiotics might reduce symptom severity, duration (other guidelines differ).
  • Synopsis authors urge balancing benefits-harms in considering multiplex molecular testing.
  • Another synopsis is available for IDSA guidelines targeting US population with persistent or infectious diarrhea .

 

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