A Review on Management of Acute Gastroenteritis and the Role of Antibiotics

Abstract

One of the most common diseases is diarrhea. An overview of epidemiology, management, and current treatments for acute diarrhea is presented, as well as a review of the most important pathogens. Following a description of the general principles of diarrhea therapy, the most important bacterial gastrointestinal infections are described in terms of targeted antimicrobial therapy, including Salmonellosis, Shigellosis, Campylobacter, as well as Escherichia coli, Yersiniosis, and Cholera infections. There has been an increase in the incidence and severity of diarrhea caused by toxigenic Clostridium difficile strains. Therefore, new aspects of treatment will be described in detail for these infections. It is still important to treat infectious diarrhea with symptomatic therapy. Patients with severe illness, such as high frequency of stools, fever, bloody diarrhea, underlying immune deficiencies, advanced age, or significant comorbidities, may benefit from empirical antibiotic therapy. Resistance to fluoroquinolones is on the rise, in particular. Infections caused by Shiga toxin-producing E. coli (STEC), C. difficile infections (CDI), and severe Colitis should not be treated with motility inhibitors. CDI recurrence can be reduced by fidaxomicin, a macrocyclic antibiotic. Additionally, there is increasing evidence that fecal microbiota transplantation is a successful treatment option for multiple recurrences of CDI. As a result, acute diarrhea is still primarily treated with supportive measures. It is not evidence-based to prescribe antibiotics for acute diarrhea.