Page updated 30 September 2006
Antibiotic Associated Diarrhoea - Management
- Source isolate all patients with diarrhoea.
- Evaluate the patient as to whether diarrhoea might be antibiotic associated. It may even start a few weeks after stopping antibiotics.
- Stop the antibiotic if it is still being prescribed.
- Start resuscitation with fluid and electrolyte replacement.
- Consider pursuing the diagnosis of pseudomembranous colitis.
- Consider specific treatment if stopping the antibiotics has no effect or if the patient is very unwell
- Use oral metronidazole as first line therapy for antibiotic associated diarrhoea.
- Use oral vancomycin as second-line therapy. Note that oral vancomycin is considered to predispose to colonisation with vancomycin-resistant enterococci).
- Vancomycin is probably the drug of choice for proven pseudomembranous colitis. The patient may need surgery.
- Report cases to Infection Control Team - if there is an outbreak (See Outbreak Management) ward closure and thoroughy cleaning should be considered.
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