Acute gastroenteritis and Infectious Diarrhoea
Most patients in whom pathogens are detected do not require specific treatment unless the patient is systemically unwell or treatment is advised by an infection or public health specialist. Empirical treatment is not recommended as the majority of acute diarrhoeal illnesses do not have an identifiable bacterial cause.
Acute diarrhoea is defined as 3 or more episodes of soft stools a day, of less than 14 days’ duration with stools soft enough to take on the shape of a sample pot. A careful travel and occupational history should be taken from any patient presenting with suspected infectious diarrhoea. Once the diarrhoea has stopped culture is no longer indicated, as recovery of the pathogen is unlikely.
In Primary care: Contact Public Health if there is a suspected public health hazard, you observe an outbreak of diarrhoea in a family or community, or if a pathogen with potential serious clinical sequelae to infection has been isolated, e.g. E. coli O157.