Acute gastroenteritis

exp date isn't null, but text field is


  • Isolate in side room and follow standard and transmission based infection control recommendations on the intranet.
  • Replace electrolytes and fluid.
  • Avoid loperamide, opiates and NSAID medication where possible
  • If patient is on a PPI/H2 antagonist review if this is still required; stop if possible.
  • If patient is septic consider treating with antibiotics as per surgical intra-abdominal infections.

Required investigations

  • Stool cultures x3
  • Stool for Norovirus PCR (or vomit - do not send vomit for culture)
  • Blood cultures if febrile

Recommended antimicrobials

  • Antibiotics worsen outcome in STEC (E.coli 0157) infection.
  • Antibiotics can prolong carriage in Salmonella infection.
  • Campylobacter/Shigella and Salmonella are usually treated conservatively.

Consider antibiotic treatment for people where Campylobacter/Shigella/Salmonella has been isolated:

  • With severe symptoms (high fever, bloody diarrhoea, or more than eight stools per day).
  • Who are immunocompromised.
  • Whose symptoms appear to be worsening.
  • Whose symptoms have lasted longer than 1 week.
Campylobacter jejuni

Clarithromycin 500mg every 12 hours orally for 5 days

Salmonella/Shigella Consider discussing with microbiology


Likely organisms: Viral, Salmonella, Campylobacter, Shigella, E.coli including STEC (O157).

  • Offer HIV testing in patients where Campylobacter/Shigella or Salmonella has been isolated.
  • Outbreaks of Shigella have been linked to person-to-person spread among men who have sex with men.