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

Vanguru Shreya
Medicine, Kamineni Institute Of Medical Sciences, India

Published on: 2024-08-30

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.

Keywords

Antibiotics, Community-acquired diarrhea, Diarrhea, Gastroenteritis, Travelers’ diarrhea

Introduction

Even in industrialized countries, acute infectious diarrhea remains a common health problem. Adults in Germany suffer from 0.95 episodes of acute gastrointestinal illness per year, according to recent data. The USA reported a similar rate. When assessing patients with acute diarrhea, one of the dilemmas is determining when to test for aetiological agents and when to initiate antimicrobial therapy. We review the management of acute gastroenteritis (GE) in adults in industrialized countries with a special focus on antibiotics. Managing persistent and chronic diarrhea, nosocomial diarrhea, and acute GE in resource-limited countries is beyond the scope of this article. There are two epidemiological settings in which acute GE can occur: communityacquired diarrhea and travelers’ diarrhea [1].