What is the treatment for enteritis?

From the Guidelines

The most effective treatment for enteritis involves a combination of symptom management and, when necessary, antibiotic therapy, with the choice of antibiotics depending on the severity and suspected cause of the infection, as well as local resistance patterns, as recommended by guidelines from the Surgical Infection Society and the Infectious Diseases Society of America 1.

General Approach to Treatment

For mild cases of enteritis, the focus is on managing symptoms to support the body's natural recovery process. This includes:

• Rest to help the body recover
• Hydration with oral rehydration solutions, such as Pedialyte, to replace lost fluids and electrolytes
• A bland diet, often referred to as the BRAT diet (bananas, rice, applesauce, toast), to ease digestion

Medications for Symptom Control

Over-the-counter medications can be used to control symptoms:

• Loperamide (Imodium) at 2mg after each loose stool (maximum 8mg/day) to help control diarrhea
• Bismuth subsalicylate (Pepto-Bismol) at 30ml or two tablets every 30-60 minutes (maximum 8 doses/day) to reduce both diarrhea and nausea

Antibiotic Therapy for Bacterial Enteritis

For cases of bacterial enteritis, antibiotic therapy may be prescribed:

• Ciprofloxacin (500mg twice daily for 3-5 days) or azithromycin (500mg once daily for 3 days) are examples of antibiotics that might be used, depending on the suspected bacterial cause and local resistance patterns 1.
• The choice of antibiotic should be guided by the severity of the infection, the presence of any complicating factors, and the results of culture and susceptibility testing when available.

Considerations for Severe Cases

Severe cases of enteritis that require hospitalization may need:

• Intravenous fluids and electrolyte replacement to manage dehydration and electrolyte imbalances
• Monitored antibiotic therapy to ensure effective treatment of the underlying infection
• Close monitoring for signs of complications, such as severe dehydration, electrolyte imbalances, or the development of sepsis.

Important Considerations

• It is crucial to complete the full course of antibiotics as prescribed to ensure the infection is fully cleared and to reduce the risk of antibiotic resistance.
• Patients should avoid dairy products and fatty foods during recovery, as these can be difficult to digest and may exacerbate symptoms.
• Medical attention should be sought immediately if symptoms include high fever, bloody diarrhea, severe abdominal pain, or signs of dehydration such as decreased urination or dizziness.

From the FDA Drug Label

Metronidazole tablets are indicated in the treatment of acute intestinal amebiasis (amebic dysentery)

• Enteritis can be caused by various factors, including bacterial, viral, or parasitic infections.
• The provided drug label for metronidazole tablets indicates that it is used to treat acute intestinal amebiasis (amebic dysentery), which is a type of enteritis.
• However, the label does not explicitly state that metronidazole is used to treat enteritis in general, but rather a specific type of enteritis caused by amebiasis.
• Therefore, based on the provided information, metronidazole tablets may be used to treat enteritis caused by amebiasis 2.

From the Research

Treatment for Enteritis

The treatment for enteritis typically involves a combination of medications and supportive care.

• Antibiotic therapy is often used to treat bacterial enteritis, with options including azithromycin, levofloxacin, and ciprofloxacin 3, 4, 5, 6.
• Loperamide may be used in combination with antibiotics to reduce gastrointestinal symptoms and duration of illness 3, 5.
• Enteral fluid therapy may be used to treat dehydration and electrolyte loss associated with diarrhea, particularly in large animals 7.
• The choice of antibiotic should take into account the travel destination and regional differences in the predominance of pathogens and resistance levels 3.

Antibiotic Options

• Azithromycin is the preferred first-line antibiotic for the treatment of acute watery diarrhea and febrile diarrhea/dysentery 3.
• Levofloxacin and ciprofloxacin are also options for acute watery diarrhea and febrile diarrhea/dysentery, but are becoming less effective due to increasing fluoroquinolone resistance 3, 4, 5, 6.
• Rifaximin is an alternative for acute watery diarrhea, but should not be used with invasive illness 3.

Supportive Care

• Enteral fluid therapy can be used to treat mild to moderately dehydrated patients with some intact intestinal epithelium and motile small intestine 7.
• Supportive care, such as rest and hydration, is also important for managing symptoms and supporting recovery.