Sandbox/diarrhea

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mugilan Poongkunran M.B.B.S [2]

Pathogen Specific

▸ Click on the following categories to expand treatment regimens.

Shigella species   ▸  Adults   ▸  Children Non-typhi species of Salmonella   ▸  Adults   ▸  Children Campylobacter species   ▸  Adults   ▸  Children Enterotoxigenic E.coli species   ▸  Adults   ▸  Children Enteropathogenic E.coli species   ▸  Adults   ▸  Children Enteroinvasive E.coli species   ▸  Adults   ▸  Children Enteroaggregative E.coli species   ▸  Adults   ▸  Children Enterohemorrhagic E.coli species   ▸  Adults   ▸  Children Aeromonas / Plesiomonas   ▸  Adults   ▸  Children Yersinia species   ▸  Adults   ▸  Children Vibrio cholerae O1 or O139   ▸  Adults   ▸  Children Toxigenic Clostridium difficile   ▸  Adults   ▸  Children Giardia species   ▸  Adults   ▸  Children Cryptosporidium species   ▸  Adults   ▸  Children Isospora species   ▸  Adults   ▸  Children Cyclospora species   ▸  Adults   ▸  Children Microsporidium species   ▸  Adults   ▸  Children Entamoeba histolytica   ▸  Adults   ▸  Children

Immunocompetent patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 3 days Alternative Regimen ▸ Ofloxacin 300 mg orally q12h X 3 days OR ▸ Norfloxacin 400 mg orally q12h X 3 days OR ▸ Ciprofloxacin 500 mg orally q12h X 3 days OR ▸ Nalidixic acid 1g orally q24h X 5 days OR ▸ Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 3 days OR ▸ Azithromycin X 3 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 7-10 days Alternative Regimen ▸ Ofloxacin 300 mg orally q12h X 7-10 days OR ▸ Norfloxacin 400 mg orally q12h X 7-10 days OR ▸ Ciprofloxacin 500 mg orally q12h X 7-10 days OR ▸ Nalidixic acid 1g orally q24h X 7-10 days OR ▸ Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 7-10 days OR ▸ Azithromycin X 7-10 days Immunocompetent patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg/kg orally q12h X 3 days Alternative Regimen ▸ Nalidixic acid 55 mg/kg/day X 5 days OR ▸ Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 3 days OR ▸ Azithromycin X 3 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg/kg orally q12h X 7-10 days Alternative Regimen ▸ Nalidixic acid 55 mg/kg/day X 7-10 days OR ▸ Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 7-10 days OR ▸ Azithromycin X 7-10 days Immunocompetent Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 5-7 days Alternative Regimen ▸ Ofloxacin 300 mg orally q12h X 5-7 days OR ▸ Norfloxacin 400 mg orally q12h X 5-7 days OR ▸ Ciprofloxacin 500 mg orally q12h X 5-7 days OR ▸ Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 5-7 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 14 days Alternative Regimen ▸ Ofloxacin 300 mg orally q12h X 14 days OR ▸ Norfloxacin 400 mg orally q12h X 14 days OR ▸ Ciprofloxacin 500 mg orally q12h X 14 days OR ▸ Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 14 days Immunocompetent Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg/kg orally q12h X 5-7 days Alternative Regimen ▸ Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 5-7 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg/kg orally q12h X 14 days Alternative Regimen ▸ Ceftriaxone 100 mg/kg/day in 2-3 divided doses X 14 days Immunocompetent Preferred Regimen ▸ Erythromycin 500 mg orally q12h X 5 days Immunocompromised ▸ Erythromycin 500 mg orally q12h X extended period Immunocompetent Preferred Regimen ▸ Erythromycin 500 mg orally q12h X 5 days Immunocompromised ▸ Erythromycin 500 mg orally q12h X extended period Immunocompetent patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 3 days Alternative Regimen ▸ Ofloxacin 300 mg orally q12h X 3 days OR ▸ Norfloxacin 400 mg orally q12h X 3 days OR ▸ Ciprofloxacin 500 mg orally q12h X 3 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 5-7 days Alternative Regimen ▸ Ofloxacin 300 mg orally q12h X 5-7 days OR ▸ Norfloxacin 400 mg orally q12h X 5-7 days OR ▸ Ciprofloxacin 500 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 3 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Erythromycin 500 mg orally q12h X 5 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 5-7 days Alternative Regimen ▸ Ofloxacin 300 mg orally q12h X 5-7 days OR ▸ Norfloxacin 400 mg orally q12h X 5-7 days OR ▸ Ciprofloxacin 500 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Erythromycin 500 mg orally q12h X 5 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Erythromycin 500 mg orally q12h X 5 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 5-7 days Alternative Regimen ▸ Ofloxacin 300 mg orally q12h X 5-7 days OR ▸ Norfloxacin 400 mg orally q12h X 5-7 days OR ▸ Ciprofloxacin 500 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Erythromycin 500 mg orally q12h X 5 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Unknown Immunocompromised patients Preferred Regimen (For ETEC) ▸ Ofloxacin 300 mg orally q12h X 5-7 days OR ▸ Norfloxacin 400 mg orally q12h X 5-7 days OR ▸ Ciprofloxacin 500 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Unknown Immunocompromised patients Preferred Regimen ▸ Unknown Immunocompetent patients Preferred Regimen ▸ Role of antibiotics unclear, and administration should be avoided Immunocompromised patients Preferred Regimen ▸ Role of antibiotics unclear, and administration should be avoided Immunocompetent patients Preferred Regimen ▸ Role of antibiotics unclear, and administration should be avoided Immunocompromised patients Preferred Regimen ▸ Role of antibiotics unclear, and administration should be avoided Immunocompetent patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 3 days Alternative Regimen ▸ Ofloxacin 300 mg orally q12h X 3 days OR ▸ Norfloxacin 400 mg orally q12h X 3 days OR ▸ Ciprofloxacin 500 mg orally q12h X 3 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 5-7 days Alternative Regimen ▸ Ofloxacin 300 mg orally q12h X 5-7 days OR ▸ Norfloxacin 400 mg orally q12h X 5-7 days OR ▸ Ciprofloxacin 500 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 3 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen (Only for severe infections or bacteremia) ▸ Doxycycline 300 mg orally single dose OR ▸ Tetracycline 500 mg orally q6h X 3 days Alternative Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 5-7 days OR ▸ Ofloxacin 300 mg orally q12h X 5-7 days OR ▸ Norfloxacin 400 mg orally q12h X 5-7 days OR ▸ Ciprofloxacin 500 mg orally q12h X 5-7 days Immunocompromised patients Preferred Regimen ▸ Doxycycline 300 mg orally single dose PLUS ▸ Tetracycline 500 mg orally q6h X 3 days Alternative Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 5-7 days OR ▸ Ofloxacin 300 mg orally q12h X 5-7 days OR ▸ Norfloxacin 400 mg orally q12h X 5-7 days OR ▸ Ciprofloxacin 500 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen (Only for severe infections or bacteremia) ▸ Doxycycline 300 mg orally single dose OR ▸ Tetracycline 500 mg orally q6h X 3 days Alternative Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 5-7 days Immunocompromised patients Preferred Regimen ▸ Doxycycline 300 mg orally single dose PLUS ▸ Tetracycline 500 mg orally q6h X 3 days Alternative Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Doxycycline 300 mg orally single dose OR ▸ Tetracycline 500 mg orally q6h X 3 days Alternative Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 3 days OR ▸ Ofloxacin 300 mg orally q12h X 3 days OR ▸ Norfloxacin 400 mg orally q12h X 3 days OR ▸ Ciprofloxacin 500 mg orally q12h X 3 days Immunocompromised patients Preferred Regimen ▸ Doxycycline 300 mg orally single dose PLUS ▸ Tetracycline 500 mg orally q6h X 3 days Alternative Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 5-7 days OR ▸ Ofloxacin 300 mg orally q12h X 5-7 days OR ▸ Norfloxacin 400 mg orally q12h X 5-7 days OR ▸ Ciprofloxacin 500 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Doxycycline 300 mg orally single dose OR ▸ Tetracycline 500 mg orally q6h X 3 days Alternative Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 5-7 days Immunocompromised patients Preferred Regimen ▸ Doxycycline 300 mg orally single dose PLUS ▸ Tetracycline 500 mg orally q6h X 3 days Alternative Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Metronidazole 250 mg orally q6h X 10 days OR ▸ Metronidazole 500 mg orally q8h X 10 days Immunocompromised patients Preferred Regimen ▸ Doxycycline 300 mg orally single dose PLUS ▸ Tetracycline 500 mg orally q6h X 3 days Alternative Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 5-7 days OR ▸ Ofloxacin 300 mg orally q12h X 5-7 days OR ▸ Norfloxacin 400 mg orally q12h X 5-7 days OR ▸ Ciprofloxacin 500 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Metronidazole 250 mg orally q6h X 10 days OR ▸ Metronidazole 500 mg orally q8h X 10 days Immunocompromised patients Preferred Regimen ▸ Doxycycline 300 mg orally single dose PLUS ▸ Tetracycline 500 mg orally q6h X 3 days Alternative Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Metronidazole 250-750 mg orally q8h X 7-10 days Immunocompromised patients Preferred Regimen ▸ Doxycycline 300 mg orally single dose PLUS ▸ Tetracycline 500 mg orally q6h X 3 days Alternative Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 5-7 days OR ▸ Ofloxacin 300 mg orally q12h X 5-7 days OR ▸ Norfloxacin 400 mg orally q12h X 5-7 days OR ▸ Ciprofloxacin 500 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen ▸ Metronidazole 250-750 mg orally q8h X 7-10 days Immunocompromised patients Preferred Regimen ▸ Doxycycline 300 mg orally single dose PLUS ▸ Tetracycline 500 mg orally q6h X 3 days Alternative Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 5-7 days Immunocompetent patients Preferred Regimen (only if severe) ▸ Paromomycin 500 mg orally q8h X 7 days Immunocompromised patients Preferred Regimen ▸ Paromomycin 500 mg orally q8h X 14-28 days THEN ▸ Paromomycin 500 mg orally q12h X if needed Immunocompetent patients Preferred Regimen (only if severe) ▸ Paromomycin 500 mg orally q8h X 7 days Immunocompromised patients Preferred Regimen ▸ Paromomycin 500 mg orally q8h X 14-28 days THEN ▸ Paromomycin 500 mg orally q12h X if needed Immunocompetent patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 7-10 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q6h X 10 days THEN ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally thrice weekly indefinitely Alternative Regimen (indefinitely for AIDS patients) ▸ Sulfadoxine 500 mg PLUS ▸ Pyrimethamine 25 mg Immunocompetent patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 7-10 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q6h X 10 days THEN ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally thrice weekly indefinitely Alternative Regimen (indefinitely for AIDS patients) ▸ Sulfadoxine 500 mg PLUS ▸ Pyrimethamine 25 mg Immunocompetent patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q12h X 7 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally q6h X 10 days THEN ▸ Trimethoprim-sulfamethoxazole 160/800 mg orally thrice weekly indefinitely Immunocompetent patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q12h X 7 days Immunocompromised patients Preferred Regimen ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally q6h X 10 days THEN ▸ Trimethoprim-sulfamethoxazole 5/25 mg orally thrice weekly indefinitely Immunocompetent patients Preferred Regimen ▸ Not determined Immunocompromised patients Preferred Regimen ▸ Albendazole 400 mg orally q12h X 21 days Immunocompetent patients Preferred Regimen ▸ Not determined Immunocompromised patients Preferred Regimen ▸ Albendazole 400 mg orally q12h X 21 days Immunocompetent patients Preferred Regimen ▸ Metronidazole 750 mg orally q8h X 5-10 days PLUS ▸ Diiodohydroxyquin 650 mg orally q8h X 20 days Alternative Regimen ▸ Metronidazole 750 mg orally q8h X 5-10 days PLUS ▸ Paromomycin 500 mg orally q8h X 7 days Immunocompromised patients Preferred Regimen ▸ Metronidazole 750 mg orally q8h X 5-10 days PLUS ▸ Diiodohydroxyquin 650 mg orally q8h X 20 days Alternative Regimen ▸ Metronidazole 750 mg orally q8h X 5-10 days PLUS ▸ Paromomycin 500 mg orally q8h X 7 days Immunocompetent patients Preferred Regimen ▸ Metronidazole 750 mg orally q8h X 5-10 days PLUS ▸ Diiodohydroxyquin 650 mg orally q8h X 20 days Alternative Regimen ▸ Metronidazole 750 mg orally q8h X 5-10 days PLUS ▸ Paromomycin 500 mg orally q8h X 7 days Immunocompromised patients Preferred Regimen ▸ Metronidazole 750 mg orally q8h X 5-10 days PLUS ▸ Diiodohydroxyquin 650 mg orally q8h X 20 days Alternative Regimen ▸ Metronidazole 750 mg orally q8h X 5-10 days PLUS ▸ Paromomycin 500 mg orally q8h X 7 days