Severe

  • > 6 diarrheal episodes/day
  • bloody diarrhea
  • persistent (> 3 days) diarrhea
  • fever

- Culture recommended.

- Tailor antibiotics to C&S results.

 
Usual Pathogens

diarrheagenic E. coli
Campylobacter spp
Shigella spp
Enterotoxigenic Bacteroides fragilis

 

Empiric Therapy Dose Duration
Azithromycin 1g PO or 1 dose
  500mg PO daily 3 days
or    
Levofloxacin 500mg PO or 1 dose
  500mg PO daily 3 days
or    
Norfloxacin 800mg PO or 1 dose
  400mg PO bid 3 days
or    
Ciprofloxacin 750mg PO or 1 dose
  500mg PO bid 3 days
or    
TMP/SMX 2 DS tabs PO or 1 dose
  1 DS tab PO bid 3 days