From the Guidelines
The primary treatment for food poisoning should focus on fluid and electrolyte therapy to prevent dehydration, with antimotility, antinausea, or antiemetic agents considered only after adequate hydration is achieved. When considering treatment options, it's essential to prioritize the patient's hydration status, as dehydration can lead to severe complications. According to the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1, fluid and electrolyte therapy is the cornerstone of treatment.
For patients with acute watery diarrhea, loperamide may be given to immunocompetent adults, but its use should be avoided in cases where toxic megacolon may result or in patients with inflammatory diarrhea or diarrhea with fever 1. In contrast, antinausea and antiemetic agents like ondansetron may be given to children over 4 years of age and adolescents to facilitate oral rehydration 1.
Key considerations in the treatment of food poisoning include:
- Rest and staying hydrated by drinking clear fluids like water, sports drinks, or oral rehydration solutions
- Taking small, frequent sips if nausea makes drinking difficult
- Avoiding solid foods initially and gradually reintroducing bland, easy-to-digest foods
- Monitoring for severe symptoms such as high fever, bloody diarrhea, severe abdominal pain, or signs of dehydration, which may indicate a more serious infection requiring medical attention.
It's crucial to note that most food poisoning cases resolve within 48 hours without antibiotics, as the body naturally eliminates the toxins or pathogens. However, if symptoms persist or severe symptoms develop, seeking medical attention is essential to determine the best course of treatment, which may include prescription medications or intravenous fluids.
From the Research
Treatment Options
- The main treatment for food poisoning is re-hydration, which is essential in managing the condition 2.
- Empirical therapy using antibiotics may be considered in high-risk patients, such as the elderly, immunocompromised, diabetes, liver cirrhosis, or intestinal hypomotility 2.
- Antibiotics are not indicated for the majority of enteric infections, but they can be used judiciously to ameliorate illness or curtail pathogen excretion and spread of disease in some diarrheal infections 3.
Medications
- Loperamide can decrease the number of unformed stools and shorten the duration of diarrhea in dysentery caused by Shigella in adults treated with ciprofloxacin 4.
- Ciprofloxacin plus loperamide can be used to treat travelers' diarrhea, but it may not be better than treatment with ciprofloxacin alone in regions where enterotoxigenic E. coli is the predominant cause 5.
- Antimicrobial agents are indicated for shigellosis, cholera, traveler's diarrhea, amebiasis, and giardiasis, as well as in some specific circumstances to treat infections caused by Campylobacter, some categories of diarrheagenic E. coli, C. difficile, nontyphoidal Salmonella, and certain Vibrionaceae 3.
Prevention and Safety
- Prevention is an important measure in the management of food poisoning by keeping food from contamination, always fresh, and maintaining good hygiene 2.
- Oral rehydration solution (ORS) is a lifesaving therapy for cholera and pediatric diarrhea, but it can be contaminated with bacteria, highlighting the need for proper preparation and storage 6.
- A simple system using bleach disinfectant and special storage vessels can prevent bacterial contamination of ORS and reduce the risk of nosocomial transmission of cholera and other enteric pathogens 6.