From the Guidelines
Age greater than 75 is not an independent indication for the use of antibiotics in diarrhea. Antibiotics, such as ciprofloxacin 500mg twice daily for 3 days or azithromycin 500mg once daily for 3 days, are typically reserved for patients with bloody stool, fever, or severe dehydration, as well as those with a travel history suggesting exposure to bacterial pathogens 1. According to the guidelines, empiric antimicrobial therapy for bloody diarrhea is not recommended in immunocompetent children and adults, except in specific situations such as infants <3 months of age with suspicion of bacterial etiology, ill immunocompetent people with fever and bacillary dysentery, or people who have recently traveled internationally with body temperatures ≥38.5°C and/or signs of sepsis 1.
- The following are indications for antibiotic use in diarrhea:
- Bloody stool
- Fever
- Severe dehydration
- Travel history suggesting exposure to bacterial pathogens
- Age >75 is not an independent indication for antibiotic use, but rather a consideration for medical intervention in the management of acute diarrhea, especially if there are concurrent chronic diseases or no abatement of symptoms after 48 hours 1.
In general, antibiotics should be used judiciously and only when clinically indicated, as their misuse can contribute to antimicrobial resistance 1.
From the Research
Indications for Antibiotic Use in Diarrhea
The following are indications for the use of antibiotics in diarrhea:
Non-Indications for Antibiotic Use in Diarrhea
The following is not an indication for the use of antibiotics in diarrhea:
- Age greater than 75, unless the patient has other risk factors such as severe dehydration, immunosuppression, or comorbidities 2, 6, 5