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Antibiotic agents for empiric treatment of adults with acute diarrhea in resource-rich settings

Antibiotic agents for empiric treatment of adults with acute diarrhea in resource-rich settings
Agent Patients with watery (nonbloody) diarrhea Patients with dysentery (diarrhea with visible blood or mucus)
Azithromycin
  • 500 mg orally once daily for three days
  • or
  • 1 g (single dose); may divide in two equal doses to reduce nausea*
  • 500 mg orally once daily for three days
Ciprofloxacin
  • 500 mg orally twice daily for three to five days
  • or
  • 750 mg (single dose)*
  • 500 mg orally twice daily for three to five days
Levofloxacin
  • 500 mg orally once daily for three to five days
  • or
  • 500 mg (single dose)*
  • 500 mg orally once daily for three to five days
Refer to UpToDate text for discussion of indications for empiric antibiotic therapy. Antibiotics may be combined with loperamide (first dose 4 mg, and then 2 mg dose after each loose stool; not to exceed 16 mg in a 24-hour period).
* If symptoms persist 24 hours after single-dose regimen, complete a three-day course using multiple-dose regimen.
Data from:
  1. UpToDate Lexidrug. More information available at https://online.lexi.com/.
  2. Riddle MS, DuPont HL, Connor BA. ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Acute Diarrheal Infections in Adults. Am J Gastroenterol 2016; 111:602.
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