Treatment guide for Viral/Bacterial diarrhoea

(see separate guidance for antibiotic associated C. difficile infection )

  • Management of fluid and electrolyte balance is the mainstay of treatment
  • Ideally the patient should be isolated in a side room with enteric precautions and infection control should be contacted for further advice.
  • Most bacterial infections are self-limiting and do not require specific antibacterial therapy as it; only reduces diarrhoea by 1-2 days, can cause resistance and is contraindicated in E. coli 0157 infection where they may enhance toxin release and increase the risk of haemolytic uraemic syndrome.
  • Consider antibacterial therapy only if there are clear signs of systemic spread or if the patient is elderly, immunocompromised or has prosthetic valves or joints, when blood should be taken for culture and the case should be discussed with a microbiologist, as antibiotic sensitivity cannot be assumed.
  • Avoid antimotility agents acutely and particularly with bloody diarrhoea.
  • Send a stool for culture. Indicate on the request card if the patient has traveled abroad, is a known contact or has been on antibiotics so that other specific pathogens are looked for.
  • If an outbreak of gastrointestinal infection is suspected on a ward the infection control team should be contacted (out-of-hours the on-call medical microbiologist).
  • If the source of the infection is thought to be "food poisoning" or the infection might be part of a suspected or known community outbreak, please contact the Public Health England Health Protection TEAM (HPT) on 0300 303 8162.