Gastroenteritis and Colitis

Antimicrobial prescribing: NHS Forth Valley
NHS Forth Valley

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 strongly suspected - review C difficile Infection (CDI) guidance and consider empirical management.

No evidence of associated systemic infection or sepsis

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

Notes:

Evidence of systemic infection or sepsis

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

Notes

Review need for antibiotics daily including any available microbiology results.