Should antibiotics be routinely given to children with acute diarrhoea?

Most cases of acute diarrhoea are caused by a virus and do not respond to antibiotics. Indication for antibiotics are:

  • Suspected septicaemia (very ill with a high fever)
  • Small infants (under 1 month)
  • Severely malnourished children
  • Dysentery (blood in the stools)
  • Suspected cholera

Infants who are sick enough to receive antibiotics should be referred to hospital for management.

Routine antibiotics should not be used to treat acute diarrhoea.

Ill infants with suspected septicaemia must receive systemic antibiotics. Dysentery (often due to Shigella) is usually treated with oral nalidixic acid (12.5 mg/kg/dose 6 hourly for 5 days) while persistent diarrhoea (often due to Amoebae or Giardia) is treated with metronidazole (Flagyl).

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