Loperamide should not be used by patients with fever or dysentery; its use may prolong diarrhea in patients with infection due to Shigella or other invasive organisms. b The recommended antibacterial drugs are as follows: Travel to high-risk country other than Thailand: Adults: (1) A fluoroquinolone such as ciprofloxacin, 750 mg as a single dose or 500 mg bid for 3 days; levofloxacin, 500 mg as a single dose or 500 mg qd for 3 days; or norfloxacin, 800 mg as a single dose or 400 mg bid for 3 days. (2) Azithromycin, 1000 mg as a single dose or 500 mg qd. | Chapter 122. Acute Infectious Diarrheal Diseases and Bacterial Food Poisoning Part 9 Loperamide should not be used by patients with fever or dysentery its use may prolong diarrhea in patients with infection due to Shigella or other invasive organisms. The recommended antibacterial drugs are as follows Travel to high-risk country other than Thailand Adults 1 A fluoroquinolone such as ciprofloxacin 750 mg as a single dose or 500 mg bid for 3 days levofloxacin 500 mg as a single dose or 500 mg qd for 3 days or norfloxacin 800 mg as a single dose or 400 mg bid for 3 days. 2 Azithromycin 1000 mg as a single dose or 500 mg qd for 3 days. 3 Rifaximin 200 mg tid or 400 mg bid for 3 days not recommended for use in dysentery . Children Azithromycin 10 mg kg on day 1 5 mg kg on days 2 and 3 if diarrhea persists. Alternative agent furazolidone mg kg per day in four divided doses for 5 days. Travel to Thailand with risk of fluoroquinoloneresistant Campylobacter . Adults Azithromycin at above dose for adults . Alternative agent a fluoroquinolone at above doses for adults . Children Same as for children traveling to other areas see above . All patients should take oral fluids Pedialyte Lytren or flavored mineral water plus saltine crackers. If diarrhea becomes moderate or severe if fever persists or if bloody stools or dehydration develops the patient should seek medical attention. Source After Dupont. The mainstay of treatment is adequate rehydration. The treatment of cholera and other dehydrating diarrheal diseases was revolutionized by the promotion of oral rehydration solutions the efficacy of which depends on the fact that glucose-facilitated absorption of sodium and water in the small intestine remains intact in the presence of cholera toxin. The use of oral rehydration solutions has reduced mortality due to cholera from 50 in untreated cases to 1 . The World Health Organization recommends a solution containing g sodium chloride g sodium bicarbonate g .
