Gastroenteritis and Colitis

Micro Organisms

Most infections will be self-limiting in nature.

Even bacterial infections e.g. Campylobacter, Salmonella are commonly self-limiting.

Send stool sample for culture. If bacterial pathogen identified, report will contain comment to guide management.

If C. difficile infection is suspected - review guidance "Clostridium difficile assocaited disease" guidance and consider empirical management.

 

No evidence of associated systemic infection or sepsis

Important: Therapy

Antibiotic therapy should be avoided due to increased risk of HUS in potential Shigatoxin-producing E.coli (e.g. 0157) infection and risk of exacerbating potential C. difficile infection

Evidence of systemic infection or sepsis

Important: Therapy

Gentamicin as per protocol

AND

Amoxicillin 1g IV 8 hourly (or Vancomycin IV as per protocol if penicillin allergy)

AND 

Metronidazole 400mg PO 8 hourly or 500mg IV 8 hourly

Notes:

Treatment duration: 5 days 

 

Oral switch guidance

Review culture results first. If no positive microbiology to guide:

Preferred regime - Co-amoxiclav 625mg PO 8 hourly

Alternative - Co-trimoxazole 960mg PO 12 hourly AND Metronidazole 400mg 8 hourly

Important: Notes

Review need for antibiotics daily including any available microbiology results.