What is the treatment for food poisoning?

Treatment of Food Poisoning

The primary treatment for food poisoning is rehydration, with additional supportive care based on symptom severity and suspected causative agent. 1

Initial Assessment and Management

• Evaluate for signs of dehydration, which is the most common serious complication of food poisoning 2
• Assess for fever, bloody diarrhea, severe abdominal cramping, or signs of sepsis, which may indicate more severe infections requiring specific treatment 2
• Determine the onset of symptoms, food consumption history (particularly raw or undercooked foods), and stool characteristics to help identify the likely causative agent 2

Rehydration Therapy

• Oral rehydration is the cornerstone of treatment for most cases of food poisoning 1
• For mild to moderate dehydration, oral rehydration solutions containing appropriate electrolytes should be administered 2
• In cases of severe dehydration or inability to tolerate oral fluids, intravenous rehydration may be necessary 2

Symptomatic Treatment

• Anti-emetics may be considered for severe vomiting that prevents adequate oral rehydration 3
• Loperamide (Imodium) may be used for non-bloody diarrhea in adults and children over 2 years of age 4
  • Adults: Initial dose of 4 mg followed by 2 mg after each loose stool, maximum 16 mg daily 4
  • Children 2-5 years: 1 mg three times daily (3 mg total daily) 4
  • Children 6-8 years: 2 mg twice daily (4 mg total daily) 4
  • Children 8-12 years: 2 mg three times daily (6 mg total daily) 4
• Do not use antimotility agents like loperamide in patients with bloody diarrhea or suspected Shiga toxin-producing E. coli infection 2

Specific Treatments Based on Causative Agent

• Bacterial food poisoning:

  • Consider empiric antibiotic therapy only for high-risk patients (elderly, immunocompromised, diabetic, cirrhotic) or those with systemic symptoms 1, 2
  • Avoid antibiotics in suspected STEC infections as they may increase the risk of hemolytic uremic syndrome 2

• Chemical food poisoning:

  • For caustic substance ingestion, do not induce vomiting or administer activated charcoal 5
  • Rinse eyes exposed to toxic substances immediately with copious amounts of water 5

• Mushroom poisoning (Amanita phalloides):

  • Consider gastric lavage and activated charcoal via nasogastric tube if presenting early 5
  • Penicillin G (300,000 to 1 million units/kg/day IV) and silymarin (30-40 mg/kg/day) are accepted antidotes 5

Decontamination Considerations

• Do not administer anything by mouth for any poisoning ingestion unless advised by poison control or emergency medical personnel 5
• Do not administer activated charcoal unless directed by poison control center or emergency medical personnel 5, 6
• Do not administer syrup of ipecac for ingestions of toxins 5, 6

When to Seek Medical Care

• Symptoms of severe dehydration (extreme thirst, dry mouth, little or no urination, severe weakness) 7, 3
• Bloody diarrhea 2, 3
• Fever above 101.5°F (38.6°C) 3
• Persistent vomiting that prevents keeping liquids down 3
• Diarrhea lasting more than 3 days 3
• Severe abdominal pain or cramping 2, 3
• Neurological symptoms such as blurry vision, muscle weakness, or tingling in the extremities 8

Prevention

• Educate patients about proper food handling, storage, and preparation 9
• Emphasize handwashing before handling food and after using the bathroom 9
• Recommend consuming only properly refrigerated and freshly prepared foods, especially regarding raw fish and seafood 2
• Report suspected outbreaks to local public health authorities 2

Special Considerations

• For suspected chemical poisoning, contact the Poison Help hotline (800-222-1222 in the US) for guidance 5
• Consider hospitalization for patients with severe symptoms, the very young, elderly, or immunocompromised 2, 1