Treatment for Infectious Gastroenteritis*

Treatment for Infectious Gastroenteritis*
Organism	Antibiotic (or Other Therapy)
Campylobacter jejuni	AzithromycinAzithromycin
Campylobacter jejuni	Ciprofloxacin †Ciprofloxacin †
Cholera (Vibrio cholerae) ‡	CiprofloxacinCiprofloxacin
	Doxycycline §Doxycycline §
	AzithromycinAzithromycin
Clostridioides difficile
	Fidaxomicin Fidaxomicin
	VancomycinVancomycin
	Metronidazole ‖Metronidazole ‖
	Monoclonal antibodies (for severe infection, to prevent recurrence)
	Fecal microbial transplant
Entamoeba histolytica	Metronidazole ¶Metronidazole ¶
Entamoeba histolytica	Tinidazole ¶Tinidazole ¶
Giardia intestinalis (G. lamblia)	TinidazoleTinidazole
	MetronidazoleMetronidazole
	NitazoxanideNitazoxanide
Shigella	CiprofloxacinCiprofloxacin
Shigella	AzithromycinAzithromycin
* Antibiotics are not indicated in most cases but may be used supportively with IV fluids to treat infections caused by specific organisms.
† Resistance is increasing.
‡ Antibiotic selection should be guided by susceptibility testing when available because resistance to doxycycline, fluoroquinolones, and sulfamethoxazole/trimethoprim (SMX/TMP) is increasing in certain areas and strains. In general, ‡ Antibiotic selection should be guided by susceptibility testing when available because resistance to doxycycline, fluoroquinolones, and sulfamethoxazole/trimethoprim (SMX/TMP) is increasing in certain areas and strains. In general,doxycycline is the recommended first-line antibiotic for non-pregnant adults. Azithromycin is first-line for children and pregnant women and second-line for others. Other recommendations vary, but SMX/TMP is generally a second-line antibiotic for children if the strain in an outbreak is susceptible. Ciprofloxacin is second- or third-line in non-pregnant adults and, although generally avoided in children, can be used as second-line if strains are resistant to SMX/TMP.is the recommended first-line antibiotic for non-pregnant adults. Azithromycin is first-line for children and pregnant women and second-line for others. Other recommendations vary, but SMX/TMP is generally a second-line antibiotic for children if the strain in an outbreak is susceptible. Ciprofloxacin is second- or third-line in non-pregnant adults and, although generally avoided in children, can be used as second-line if strains are resistant to SMX/TMP.
§ This antibiotic should not be given to pregnant women.
‖ Metronidazole is not recommended but may be used in patients intolerant of vancomycin and fidaxomicin.‖ Metronidazole is not recommended but may be used in patients intolerant of vancomycin and fidaxomicin.
¶ Treatment should be followed by a course of iodoquinol for 20 days or paromomycin for 7 days.¶ Treatment should be followed by a course of iodoquinol for 20 days or paromomycin for 7 days.

* Antibiotics are not indicated in most cases but may be used supportively with IV fluids to treat infections caused by specific organisms.

† Resistance is increasing.

‡ Antibiotic selection should be guided by susceptibility testing when available because resistance to doxycycline, fluoroquinolones, and sulfamethoxazole/trimethoprim (SMX/TMP) is increasing in certain areas and strains. In general, ‡ Antibiotic selection should be guided by susceptibility testing when available because resistance to doxycycline, fluoroquinolones, and sulfamethoxazole/trimethoprim (SMX/TMP) is increasing in certain areas and strains. In general,doxycycline is the recommended first-line antibiotic for non-pregnant adults. Azithromycin is first-line for children and pregnant women and second-line for others. Other recommendations vary, but SMX/TMP is generally a second-line antibiotic for children if the strain in an outbreak is susceptible. Ciprofloxacin is second- or third-line in non-pregnant adults and, although generally avoided in children, can be used as second-line if strains are resistant to SMX/TMP.is the recommended first-line antibiotic for non-pregnant adults. Azithromycin is first-line for children and pregnant women and second-line for others. Other recommendations vary, but SMX/TMP is generally a second-line antibiotic for children if the strain in an outbreak is susceptible. Ciprofloxacin is second- or third-line in non-pregnant adults and, although generally avoided in children, can be used as second-line if strains are resistant to SMX/TMP.

§ This antibiotic should not be given to pregnant women.

‖ Metronidazole is not recommended but may be used in patients intolerant of vancomycin and fidaxomicin.‖ Metronidazole is not recommended but may be used in patients intolerant of vancomycin and fidaxomicin.

¶ Treatment should be followed by a course of iodoquinol for 20 days or paromomycin for 7 days.¶ Treatment should be followed by a course of iodoquinol for 20 days or paromomycin for 7 days.

In these topics

Overview of Gastroenteritis