What is the treatment for food poisoning?

Treatment for Food Poisoning

The cornerstone of food poisoning treatment is rehydration, with additional supportive care based on symptoms, while antibiotics should be reserved for high-risk patients or specific pathogens. 1

Initial Assessment and Management

• Food poisoning symptoms typically include nausea, vomiting, watery diarrhea, abdominal pain, cramps, and fever, which may appear within hours or days after consuming contaminated food 2
• Contact a poison control center immediately for guidance in severe cases, especially when patients show signs of life-threatening conditions such as altered mental status, seizures, difficulty breathing, or persistent vomiting 3
• Do not administer milk or water as dilution therapy for ingested toxins, as there is insufficient evidence of benefit and potential for adverse effects including emesis and aspiration 3, 4
• Do not induce vomiting with ipecac syrup as it provides no clinical advantage, may cause intractable emesis, and can delay appropriate care 4, 5

Rehydration and Supportive Care

• Rehydration is the primary intervention for food poisoning management, especially important in children who have higher extracellular fluid component and greater risk of dehydration 1, 6
• Provide oral rehydration solutions for mild to moderate dehydration; consider intravenous fluids for severe dehydration or inability to tolerate oral intake 1
• Assess for signs of dehydration including decreased urine output, dry mucous membranes, decreased skin turgor, and altered mental status 6
• Supportive care should include rest, gradual reintroduction of bland foods after vomiting subsides, and symptomatic treatment for fever and pain as needed 1

Gastrointestinal Decontamination

• Activated charcoal may be considered in specific poisoning cases when a patient presents soon after ingestion (ideally within 1-4 hours), has an intact airway, and the toxin is known to be adsorbed by charcoal 5, 4
• Standard dose of activated charcoal is 1 g/kg orally in slurry form 4, 5
• Activated charcoal is contraindicated for caustic substance ingestions (strong acids or bases) and should not be administered by lay rescuers without direction from poison control centers 5
• In mushroom poisoning (e.g., Amanita phalloides), early gastric lavage and activated charcoal via nasogastric tube may be beneficial 4, 5

Specific Treatments Based on Etiology

• For suspected bacterial food poisoning, empirical antibiotic therapy may be considered only for high-risk patients (elderly, immunocompromised, diabetic, liver cirrhosis) or those with severe symptoms 1
• For salicylate poisoning, extracorporeal treatment (hemodialysis) is recommended for severe cases with altered mental status, acute respiratory distress syndrome, or failure to respond to standard therapy 4
• For mushroom poisoning, specific antidotes may include penicillin G (300,000 to 1 million units/kg/day intravenously) and silymarin (30-40 mg/kg/day orally or intravenously for 3-4 days) 4

Special Considerations

• Children require careful assessment of hydration status and appropriate fluid replacement based on weight and degree of dehydration 6
• Immunocompromised patients, elderly, and children are more susceptible to severe food poisoning and may require more aggressive intervention 1
• Evaluate for specific food poisoning syndromes based on symptom onset time, food history, and clinical presentation to guide targeted treatment 7
• Consider diagnostic testing (stool cultures, toxin assays) in severe cases, outbreaks, or when symptoms persist beyond 3 days 1, 7

Prevention

• Maintain good hygiene practices including handwashing before food preparation and consumption 1
• Keep food properly refrigerated and thoroughly cooked 1
• Avoid cross-contamination between raw and cooked foods 1
• In suspected outbreaks, notify public health authorities to prevent further cases 7, 8