[Acute diarrhea: a rational approach to prescribing antibiotics]

Acute gastroenteritis is a frequent reason for medical consultations and antibiotic prescriptions. In most cases, antibiotics are not needed, even for bacterial gastroenteritis. Microbiological diagnosis should be performed in conjunction withantibiotic prescription to better target the pathogen. Multiplex polymerase chain reaction panels offer short turnaround times for results, which should however be interpreted with caution due to possible false-positive results. The general principle is: "Test if you are going to treat, and treat only if you have tested."This article summarizes the situations in which microbiological diagnosis is needed and the situations in which empiric antibiotic treatmentis recommended before microbiological results are available, as opposed to situations in which targeted antibiotic treatment can be introduced once a pathogen has been identified.