[Antimicrobial treatment of diarrhea of infectious origin]

Since dehydration is the most frequent complication of acute diarrhoea, fluid and electrolyte repletion are the most important components of treatment. In mild diarrhoea and cases where the etiologic agent is unknown there is no need for antimicrobial chemotherapy. Indeed the benefit of an antibiotic has never been proven in these cases. Moreover side effects can occur: change in gut flora causing chronic diarrhoea, selection of drug-resistant strains, pseudomembranous colitis, toxicity of the drug. Antibiotics are often useless because a large number of diarrhoeal illnesses are caused by viruses or are of nonmicrobial origin (Rotaviruses may be responsible for up to 60% of winterdiarrhoea in children). When the diagnosis is in doubt between a primary bowel infection and a septicaemic illness antibiotic therapy is of course fully justified.