Guideline Use

Dose recommendations are based on patients with normal renal function. Refer to dosing in renal impairment

These guidelines may not be appropriate for patients with a history of multi-drug resistant organisms. Consider infectious disease consultation


Management Considerations

Empiric antibiotics for non-CDI infectious diarrhea minimally effects duration of illness and increase risk of side effects and antibiotic resistance

Severe Disease:

  • ≥6 unformed stools per 24 hours; AND 
    • Signs or symptoms of severe dehydration
    • Severe abdominal pain
    • Fever and signs of invasive diseases

High-Risk for Severe Disease:

  • Immunocompromised (including HIV)
  • Pregnancy

Radiographic diagnosis of colitis alone is not an indication for systemic antibiotics

Viral etiologies are the most common causes of gastroenteritis and warrant supportive care only

Additional Notes

Last Updated: February, 2021

These recommendations are meant to guide empiric therapeutic decision making and should not replace sound clinical decision making. Definitive therapy should be based on culture and susceptibility reports

  • Rebekah Gass, MD
  • Kyle Massey, PharmD

Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clinical infectious Diseases 2017: 65: 12 PMID: 29053792