Gastroenteritis

Base treatment on the presence of fecal leukocytes or clinical picture:

1. Ciprofloxacin (Cipro) 500 mg PO bid [C]

2. TMP/SMX DS (Bactrim DS, Septra DS) 1 tablet PO bid [C; D in 3rd trimester] PLUS (to cover Campylobacter)

Erythromycin 500 mg PO qid [B, except estolate contraindicated]

3. Amoxicillin/clavulanate (Augmentin) 500 mg PO tid PLUS (to cover Campylobacter)

Erythromycin 500 mg PO qid [B, except estolate contraindicated] Course: 3-5 days

Organisms: Shigella, Salmonella, Campylobacter, enteroinvasive E. coli, Yersinia Helicobacter pylori (associated with non-NSAID induced duodenal or gastric ulcers) Regimen A (Note four drug therapy)

Bismuth subsalicylate (Pepto-Bismol) 2 tabs PO qid with meals and at bedtime [D] PLUS

Metronidazole (Flagyl) 500 mg PO bid OR 250 mg PO qid with meals and at bedtime [B, contraindicated 1st trimester] PLUS

Tetracycline (Achromycin) 500 mg PO qid before meals and at bedtime [D] (doxycycline has lower efficacy; do not substitute) PLUS

Omeprazole (Prilosec) 20 mg PO bid before meals [C] Regimen B (Note three drug therapy)

Metronidazole (Flagyl) 500 mg PO bid OR 250 mg PO qid with meals and at bedtime [B, contraindicated 1st trimester] OR

Amoxicillin (Amoxil) 1 g PO bid OR 500 mg PO qid [B]

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