Treatments of Acute Gastroenteritis

Acute Gastroenteritis is usually self-limiting and resolves within a week after onset of symptoms. Treatment should consist of supportive measures including fluid repletion and nutrition. There is no evidence that a BRAT or low-residue diet (i.e., bananas, rice, applesauce, toast) hastens recovery time with AGE, however if it is easier for patients to tolerate, so it can be helpful.

Fluid repletion in those who are demonstrating mild to moderate dehydration, oral rehydration solutions such as pedialyte can be more effective than sports drinks in maintaining electrolyte balance and hydration. If you suspect severe dehydration (clinical signs include tachycardia, hypotension, pallor, poor skin turgor), IV fluids are usually necessary and warrant an ER referral.

There is a widespread misconception among the public that antibiotics are the cure all for any kind of illness including viral gastroenteritis. We need to reassure patients that acute gastroenteritis is almost always viral and in most cases is self-limiting. Prescribing antibiotics for a viral illness only increases antibiotic resistance and puts people at risk for contracting conditions such as C. diff.

Empiric antimicrobial therapy is recommended for patients with severe diarrhea suspected from traveling. Trimethoprim-sulfamethoxazole or Bactrim DS at 1 tab BID × 3d is effective. Other antibiotics that are effective for milder forms of illness include ciprofloxacin (Cipro) 500 mg, norfloxacin (Noroxin) 400 mg, or ofloxacin (Floxin) 300 mg.

Proper handwashing is the best way to do this! Any infant or child with infectious diarrhea should not attend daycare until the diarrhea has stopped. 

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