Specific Therapy of Acute Diarrhea

Shigella:

-Trimethoprim/SMX, (Bactrim) one DS tab PO bid for 5 days OR -Ciprofloxacin (Cipro) 500 mg PO bid for 5 days OR -Azithromycin (Zithromax) 500 mg PO x 1, then 250 mg PO qd x 4.

Salmonella (bacteremia):

-Ofloxacin (Floxin) 400 mg IV/PO q12h for 14 days OR -Ciprofloxacin (Cipro) 400 mg IV q12h or 750 mg PO q12h for 14 days OR -Trimethoprim/SMX (Bactrim) one DS tab PO bid for 14 days OR -Ceftriaxone (Rocephin) 2 gm IV q12h for 14 days. Campylobacter jejuni:

-Erythromycin 250 mg PO qid for 5-10 days OR

-Azithromycin (Zithromax) 500 mg PO x 1, then 250 mg PO qd x 4 OR

-Ciprofloxacin (Cipro) 500 mg PO bid for 5 days.

Enterotoxic/Enteroinvasive E coli (Travelers Diarrhea): -Ciprofloxacin (Cipro) 500 mg PO bid for 5-7 days OR -Trimethoprim/SMX (Bactrim), one DS tab PO bid for 5-7 days.

Antibiotic-Associated and Pseudomembranous Colitis (Clostridium difficile):

-Metronidazole (Flagyl) 250 mg PO or IV qid for 10-14 days OR -Vancomycin 125 mg PO qid for 10 days (500 PO qid for 10-14 days, if recurrent).

Yersinia Enterocolitica (sepsis):

-Trimethoprim/SMX (Bactrim), one DS tab PO bid for 5-7 days OR -Ciprofloxacin (Cipro) 500 mg PO bid for 5-7 days OR -Ofloxacin (Floxin) 400 mg PO bid OR -Ceftriaxone (Rocephin) 1 gm IV q12h.

Entamoeba Histolytica (Amebiasis): Mild to Moderate Intestinal Disease:

-Metronidazole (Flagyl) 750 mg PO tid for 10 days OR -Tinidazole 2 gm per day PO for 3 days Followed By: -Iodoquinol 650 mg PO tid for 20 days OR -Paromomycin 25-30 mg/kg/d PO tid for 7 days. Severe Intestinal Disease:

-Metronidazole (Flagyl)750 mg PO tid for 10 days OR -Tinidazole 600 mg PO bid for 5 days Followed By: -Iodoquinol 650 mg PO tid for 20 days OR -Paromomycin 25-30 mg/kg/d PO tid for 7 days. Giardia Lamblia:

-Quinacrine 100 mg PO tid for 5d OR -Metronidazole 250 mg PO tid for 7 days. Cryptosporidium:

-Paromomycin 500 mg PO qid for 7-10 days [250 mg].

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