Treatment acute diarrhea
(Am J Gastro 2016;111:602; Clin Infect Dis 2017;65:e45)
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If no WS, nl PO intake → supportive: hydrate, loperamide, bismuth subsalicylate (Ø antichol)
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If mod. dehydration: 50–200 mL/kg/d of oral solution or Gatorade, etc. If severe: IV fluids.
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If suspect traveler’s diarrhea → azithro 1 g x 1 d (due to FQ resistance in Asia), rifaximin, or rifamycin; if suspect protozoal → flagyl or nitazoxanide
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Empiric abx for non–C. diff inflammatory diarrhea reasonable for severe disease (fever, >6 BMs/d, hospitalization, bloody or mucoid stools or high-risk Pt [> 70 yrs, immunosupp]: azithro 1 g x 1 d (preferred if fever or dysentery) or FQ × 3–5 d (↑ resistance)
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Avoid abx if suspect E. coli O157:H7 (exposure hx, gross blood) as may ↑ risk of HUS
Explain by ChatGPT
If the person has no watery stool, then they should take in normal amounts of food by mouth and stay hydrated. If the person has moderate dehydration, they should drink 50-200 mL/kg/d of an oral solution like Gatorade. If the person has severe dehydration, they should receive IV fluids.
If the person has traveler’s diarrhea, they should take azithromycin, rifaximin, or rifamycin. If the person has a protozoal infection, they should take flagyl or nitazoxanide.
If the person has non-C. diff inflammatory diarrhea and is feverish, they should take empiric antibiotics. However, if the person has E. coli O157:H7, they should avoid antibiotics as it may increase the risk of HUS.
窩的英文不太好
如果此人沒有水樣便，那麼他們應該經口進食正常量的食物並保持水分。如果此人有中度脫水，他們應該飲用 50-200 mL/kg/d 的口服液，如佳得樂。如果此人嚴重脫水，他們應該接受靜脈輸液。
如果患者患有旅行者腹瀉，則應服用阿奇黴素、利福昔明或利福黴素。如果這個人有原蟲感染，他們應該服用 flagyl 或 nitazoxanide。
如果此人有非 C。 diff 炎症性腹瀉和發燒，他們應該服用經驗性抗生素。但是，如果此人患有大腸桿菌 O157:H7，則應避免使用抗生素，因為這可能會增加 HUS 的風險。