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Prevention of antimicrobial resistance

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Perfect Health Mela HCFI-WHO Consensus: No blood in stools, no antibiotics

  • For most patients with acute watery diarrhea (unless cholera), do not routinely administer empiric antimicrobial therapy.
  • Multiple pathogens can cause watery diarrhea.
  • Severe volume depletion is the most important complication of acute diarrhea in adults.
  • The clinical assessment of the adult patient with acute diarrhea should focus on characterizing the type of diarrhea (watery versus bloody) and the degree of volume depletion.
  • A microbiologic diagnosis is not needed in most cases of diarrhea in adults in resource-limited countries.
  • Adequate fluid and electrolyte replacement and maintenance are essential to the management of all diarrheal illnesses.
  • Onlyadults with bloody diarrhea should be treated promptly with an antimicrobial that is effective against Shigella or E. histolytica.
  • Bloody diarrhea means any diarrheal episode in which the loose or watery stools contain visible red blood. It excludes episodes in which blood is present in streaks on the surface of formed stool, is detected only by microscopic examination or biochemical tests, or in which stools are black owing to the presence of digested blood (melena).

Dr KK Aggarwal

Padma Shri Awardee

President Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

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