From the FDA Drug Label
Infectious Diarrhea caused by Escherichia coli (enterotoxigenic strains), Campylobacter jejuni, Shigella boydii†, Shigella dysenteriae, Shigella flexneri or Shigella sonnei† when antibacterial therapy is indicated.
The management for enteritis may include ciprofloxacin, as it is indicated for the treatment of infectious diarrhea caused by susceptible strains of microorganisms. However, antibacterial therapy should only be used when indicated, and culture and susceptibility tests should be performed to determine the causative organism and its susceptibility to ciprofloxacin.
- Key considerations:
- Appropriate therapy should be administered if anaerobic organisms are suspected of contributing to the infection.
- Therapy with ciprofloxacin may be initiated before results of culture and susceptibility tests are known.
- Resistance may develop during treatment, and culture and susceptibility testing should be performed periodically during therapy. 1
From the Research
The management of enteritis primarily involves supportive care, including adequate hydration and electrolyte replacement, with oral rehydration solutions being the first line of treatment for mild cases. For severe cases with significant dehydration, intravenous fluids may be necessary 2. Diet modification is important, with patients recommended to follow the BRAT diet (bananas, rice, applesauce, toast) initially, then gradually return to a normal diet as symptoms improve. Medications include anti-diarrheals such as loperamide (Imodium) for symptomatic relief, though these should be avoided if there's suspicion of invasive bacterial infection 3. Antibiotics are only indicated for specific bacterial causes, and probiotics such as Lactobacillus or Saccharomyces boulardii may help restore normal gut flora 4.
Key Considerations
- Oral rehydration therapy is effective and should be the first line of treatment for mild to moderate dehydration 5, 2.
- Intravenous rehydration is necessary for severe dehydration or when oral rehydration fails 6, 2.
- Antiemetics and anti-diarrheals can be used for symptomatic relief, but with caution regarding their potential to mask symptoms of invasive bacterial infections 3.
- Antibiotics should only be used for specific bacterial causes, as their misuse can lead to complications and antibiotic resistance 3, 4.
Treatment Approach
- Oral rehydration solutions should be used for mild cases, with the goal of replacing lost fluids and electrolytes 2.
- Intravenous fluids should be considered for severe dehydration or when oral rehydration is not tolerated or fails 6, 2.
- Diet modification, starting with the BRAT diet, can help manage symptoms and support recovery 3, 4.
- Medications, including anti-diarrheals and antibiotics, should be used judiciously based on the cause and severity of the enteritis 3, 4.
Given the most recent and highest quality evidence, the approach to managing enteritis should prioritize oral rehydration, supportive care, and judicious use of medications to minimize morbidity, mortality, and improve quality of life 2.