A recent study examined the management of acute diarrhea in the emergency department (ED) of a large university medical center. The study followed adult patients (age ≥18 years) over ten months, presenting to the ED with acute diarrhea.

• It reviewed data for 780 patients and excluded 101 patients.
• Among the 679 included patients with acute community-acquired diarrhea, 85.7% got discharged home and constituted the study cohort of mostly healthy adults (mean age: 32.5 ± 14.5 years).
• 26% of patients received antibiotic prescriptions at discharge.
• 28% of the patients displayed an inappropriate use of antibiotics.
• The presence of fever, leukocytosis and older age predicted antibiotic prescription.
• Patients with dehydration, comorbidities or bloody diarrhea mostly received antibiotics.
• 12.4% and 11.7% of the patients, respectively, underwent Microbiological studies and cross-sectional imaging, but it provided a very low yield (<10% for both), resulting in significantly higher visit charges.
• Inappropriately prescribed antibiotics at discharge caused higher charges in the ED than no antibiotic prescription.

This study proves that acute diarrhea management in ED remains suboptimal and does not adhere to practice guidelines. This further causes unnecessary antibiotic prescriptions, investigations, and costs.

Jabak SJ, Kawam L, El Mokahal A, Sharara AI. Management of acute diarrhea in the emergency department of a tertiary care university medical center. Journal of International Medical Research. 2022;50(8). doi:10.1177/03000605221115385