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Indicators for antibiotic therapy in invasive bacteria diarrhoea
Journal of Diarrhoeal Diseases Research
|September 1, 1994
Summary
Clinical indicators for antibiotic use in childhood diarrhoeal diseases (DD) showed low predictive value. Bloody stools and fever were weakly associated with bacterial pathogens, suggesting cautious antibiotic prescription.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Microbiology
Background:
- Diarrhoeal diseases (DD) are a major cause of childhood morbidity.
- Antibiotic therapy is frequently prescribed for DD, but its efficacy depends on the causative agent.
- Determining appropriate clinical indications for antibiotic use in children with DD is crucial.
Purpose of the Study:
- To evaluate the clinical indications for antibiotic therapy in children with diarrhoeal diseases.
- To assess the predictive value of various clinical signs and symptoms for bacterial enteric pathogens.
Main Methods:
- A study of 619 children aged 6-59 months with diarrhoea.
- Analysis of clinical data including stool characteristics, fever, and abdominal symptoms.
- Correlation of clinical findings with bacterial isolation from stool samples.
Main Results:
- Clinical variables showed low positive predictive value (PPV) for bacterial enteric pathogens.
- Grossly bloody diarrhoea had a PPV of 20.8% for any enteric pathogen.
- Elevated body temperature (>37.5°C) had a PPV of 19.6%.
Conclusions:
- Antibiotic use in children with DD should be guided by specific indicators.
- Bloody stools, mucoid stools, and fever suggest potential bacterial infection warranting antibiotics.
- Presence of stool leukocytes or erythrocytes may indicate the need for antibiotics or amoebicides.