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Antimicrobial treatment of diarrhea/acute gastroenteritis in children

R Cohen1, J Raymond2, D Gendrel3

  • 1Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Unité Court Séjour, Petits Nourrissons, Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, France; Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Saint-Maur des Fossés, France; Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie (GPIP), Saint-Maur des Fossés, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|January 2, 2018
PubMed

Insights

This guide outlines antibiotic treatment for bacterial acute gastroenteritis (AGE), focusing on Shigella, Campylobacter, and Salmonella infections. It emphasizes specific antibiotics like azithromycin, ceftriaxone, and ciprofloxacin, advising against empirical treatment without diagnosis.

Area of Science:

  • Pediatric Infectious Diseases
  • Gastroenterology
  • Microbiology

Background:

  • Acute gastroenteritis (AGE) is frequently viral, with bacterial causes being less common.
  • Bacterial pathogens like Shigella, Vibrio cholerae, Campylobacter, and Salmonella can cause AGE.
  • Antibiotic treatment for bacterial AGE is indicated only in specific circumstances and for certain pathogens.

Purpose of the Study:

  • To provide evidence-based recommendations for antibiotic treatment of bacterial AGE.
  • To align with the latest European guidelines for pediatric infectious diseases and gastroenterology.

Main Methods:

  • Review of current European Society of Pediatric Infectious Diseases and European Society of Pediatric Gastroenterology and Nutrition guidelines.
  • Identification of bacterial pathogens requiring antibiotic intervention.
  • Specification of preferred antibiotics for indicated bacterial AGE cases.

Main Results:

  • Azithromycin is the primary choice for Shigella and Campylobacter infections.
  • Ceftriaxone and ciprofloxacin are recommended for antibiotic-treated Salmonella infections.
  • Empirical antibiotic treatment for AGE without bacteriological confirmation is generally discouraged.

Conclusions:

  • Specific bacterial pathogens necessitate targeted antibiotic therapy in AGE.
  • Adherence to guideline-recommended antibiotics ensures appropriate management.
  • Bacteriological documentation is crucial before initiating antibiotic treatment for AGE.

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