NAG Gastrointestinal Infections as of Nov 2017

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  GASTROINTESTINAL TRACT INFECTIONS National Antibiotic Guidelines I.   ACUTE DIARRHEA AND GASTROENTERITIS A.   Acute Diarrhea in Children Etiology: Community and hospital-based based studies in children < 5 years Salmonella Etiology of acute diarrheas in developing countries expressed in   weighted annual incidence per 100 child years <12 months Escherichia coli Cryptosporidium 12-23 months Shigella 24-59 months ShigellaVibrio cholera  Preferred Regimen: IMCI protocol Neonate up to 2 months: Child 2 months to 5 years: Suspected dysentery:  Ciprofloxacin Ciprofloxacin  Suspected cholera:  _____ Erythromycin OR Tetracycline Acute diarrhea ã   Severe dehydration ã   Some dehydration ã   No dehydration  GASTROINTESTINAL TRACT INFECTIONS National Antibiotic Guidelines Recommendations of Feigin and Cherry: Indication Preferred Regimen: Metronidazole OR   Vancomycin CiprofloxacinORAzithromycinORCeftriaxone  Campylobacter    AzithromycinORErythromycin  Entamoeba histolytica   Metronidazole  Giardia Metronidazole  Cyclospora Trimethoprim-sulfamethoxazoleTMPSMX Comments: C. difficile   B.   Gastroenteritis (infectious diarrhea) In adults MILD DIARRHEA Preferred Regimen:  GASTROINTESTINAL TRACT INFECTIONS National Antibiotic Guidelines MODERATE DIARRHEA Preferred Regimen: Comments: SEVERE DIARRHEAEtiologies: BacterialShigellaSalmonellaC. jejuni, C. difficileE. coliK. oxytoca Parasitic:Giardia lamblia, E. histolyticaCryptosporidium  Preferred Regimen: Empiric therapy: Specific therapy: CiprofloxacinORLevofloxacinORAzithromycin Campylobacter  ORCotrimoxazole  Entamoeba histolytica: MetronidazoleORTinidazole  Vibrio cholera: DoxycyclineOR   TetracyclineORCotrimoxazole  Shigella CotrimoxazoleORCiprofloxacin    C.   Primary spontaneous bacterial peritonitis (SBP) Etiology: P:  S. pneumoniaeE. coli StreptococcusKlebsiella pneumoniae A: EnterobacteriaceaeS. pneumoniaeEnterococcusKlebsiella    GASTROINTESTINAL TRACT INFECTIONS National Antibiotic Guidelines Preferred Regimen: PEDIATRICS ADULTS S. pneumoniae: CefotaximeOR Ceftriaxonepenicillin sensitive S. pneumoniae :PenicillinGram-negative bacilli: CefotaximeORCeftriaxoneWITH or WITHOUTGentamicinORPiperacillin tazobactamorAmpicillin-sulbactam 1st line: CefotaximeORAmpicillin-sulbactam ORPiperacillin-tazobactamORCeftriaxoneORErtapenem 2nd line: E. coliKlebsiella MeropenemDOT: Comments: Antibiotic Prophylaxis: Indications: NorfloxacinORCeftriaxone   NorfloxacinOR Ciprofloxacin DOP for SBP   ã   ã  
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