4.2 Acute Gastroenteritis
| Type of Infection | First Line (with Dosage and Duration) |
Alternative First Line (with dosage and Duration) |
Comments |
|---|---|---|---|
| Acute onset diarrhoea with no danger signs* | No antibiotic required | -- | Mostly caused by viruses or self-limiting bacterial pathogens. Oral hydration with ORS or other isotonic liquids is recommended. |
| Acute onset diarrhoea with danger signs* | Azithromycin 500mg OD for 3 days | Cefixime 400mg BD for 5 days Or Inj Ceftriaxone 2g IV OD (if admitted) for 5 days | Rehydration either oral or IV fluids is essential. Avoid fluoroquinolones as high resistance reported in India (NCDC and ICMR data). |
| Persistent diarrhoea or Chronic Diarrhoea | Avoid empirical antibiotics | Look for pathogens on stool routine microscopy and modified AFB stain (for coccidian parasites) and stool culture. Administer antimicrobials as per pathogen isolated. |
For common etiological agents of Acute Gastroenteritis, see Annexure B.4.2
Additional Information
Danger signs in Acute Gastroenteritis are:
- Severe dehydration requiring IV fluids
- Dysentery (blood in stool): perform stool routine microscopy to rule out Entamoeba histiolytica and add metronidazole 400mg TDS (preferably oral)
- Elderly with poor oral intake
- Immunocompromised condition