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Gastrointestinal infections 

Gastrointestinal infections
Chapter:
Gastrointestinal infections
Author(s):

Peter Davey

, Mark Wilcox

, William Irving

, and Guy Thwaites

DOI:
10.1093/med/9780199689774.003.0025
Page of

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date: 12 April 2021

On any one day 200 million people are suffering from acute infective gastroenteritis. Restoration of fluids and electrolytes is the mainstay of treatment; oral rehydration therapy has had a significant impact in reducing mortality in developing countries. Antibiotics are not indicated unless there are signs of systemic infection and carry the risk of directly irritating an inflamed bowel mucosa. About 20 per cent of cases of antibiotic-associated diarrh-ea are caused by tox-in producing strains of Clostridium difficile. All antibiotics may induce C. difficile infection and toxin production, but clindamycin, and broad-spectrum β‎-lactam antibiotics (especially amoxicillin, ampicillin, and cephalosporins) and quinolones are most commonly incriminated. C. difficile infection should be suspected in any patient with diarrhoea in hospital, in any patient who has recently been in hospital or any patient who has recently received antibiotics in the community. Oral metronidazole or vancomycin is usually effective but recurrence is common.

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