-
Management of fluid and electrolyte balance
is the mainstay of treatment
-
Ideally the patient should be isolated in a
side room with
enteric precautions
and
infection control should be contacted
for further advice.
-
Most bacterial infections are self-limiting
and do not require specific antibacterial therapy as it; only reduces
diarrhoea by 1-2 days, can cause resistance and is contraindicated in
E.
coli 0157 infection where they may enhance toxin release and increase the
risk of haemolytic uraemic syndrome.
-
Consider antibacterial therapy only if there
are clear signs of systemic spread or if the patient is elderly,
immunocompromised or has prosthetic valves or joints, when blood should be
taken for culture and the case should be discussed with a medical
microbiologist or infectious disease physician, as antibiotic sensitivity
cannot be assumed.
-
Avoid antimotility agents
acutely and particularly with bloody diarrhoea.
-
Send a stool for culture. Indicate on the
request card if the patient has travelled abroad, is a known contact or has
been on antibiotics so that other specific pathogens are looked for.
-
If an outbreak of gastrointestinal infection
is suspected on a ward the infection control team should be contacted
(out-of-hours the on-call medical microbiologist).
-
If a food source or community outbreak is
suspected - contact the Consultant in Communicable Disease Control (CCDC)
(Tel: 01623 819 000).
