Table 8.
Bacterial gastroenteritis and antimicrobial active on germs responsible
| Pathogen | Sensitive antimicrobial | Indications for therapy |
|---|---|---|
| Aeromonas spp | – Ciprofloxacin (250–350 mg, 2 every 12 hours) – Cephalosporins III (cefotaxime 25–80 mg/kg IV every 12 hours) – Meropenem (20 mg/kg IV every 8 hours) – Aminoglycosides (gentamicin 4 mg/kg IV every 24 hours) |
In invasive forms |
| Campylobacter spp | – Azithromycin (5 mg/kg every 12 hours or10 mg/kg every 24 hours) – Erythromycin (10–15 mg/kg IV every 8 hours) |
In invasive forms |
| Clostridium difficile | – Metronidazole (7.5–10 mg/kg OS/IV every 8 hours) – Vancomycin (10 mg/kg OS every 6 hours) |
Therapy should be initiated only if diarrhea persists after a suspension of antibiotic therapy |
| Escherichia coli | – Cephalosporins III (ceftriaxone 50 mg/kg IV every 24 hours) – Aminoglycosides (amikacyn 7.5 mg/kg every 8–12 hours) (EPEC) – Meropenem (20 mg/kg Iv every 8 hours) (EPEC) – Azithromycin (5 mg/kg every 12 hours or or10 mg/kg every 24 hours) (EHEC) – Ciprofloxacin (250–350 mg every 12 hours) (ETEC; EAEC) – Rifaximin (>12 years: 200 mg every 8–12 hours) (EAEC) |
If systemic complications. The use of antibiotics increases the risk of hemolytic uremic syndrome |
| Helicobacter pylori | – Amoxicillin (70 mg/kg every 8–12 hours) + – Clarithromycin (7.7 mg/kg every 12 hours) |
Add one of the related drugs: omeprazole 20 mg, lansoprazole 30 mg, pantoprazole 40 mg, rabeprazole 20 mg, esomeprazole 20 mg) every 12 hours |
| Pleiomonas spp | – Ciprofloxacin (250–350 mg every 12 hours) – Azithromycin (5 mg/kg or10 mg/kg every 12 hours or10 mg/kg every 24 hours) – Trimethoprim-sulfamethoxazole (4–20 mg/kg orally every 12 hours) |
In invasive forms |
| Salmonella spp | – Ampicillin or amoxicillin (100 mg/kg IV every 6 hours) or cephalosporins III (ceftriaxone 50 mg/kg IV every 24 hours) | In invasive forms. Therapy prolongs the carrier state; however, recommended under 3 months of age for the high incidence of bacteremia. 3–5 days if there is bacteremia, or 1–4 weeks if there is involvement of the meninges |
| Shigella spp | – Ciprofloxacin (250–350 mg every 12 hours) – Cephalosporins III (ceftriaxone 50 mg/kg IV every 24 hours) – Azithromycin (5 mg/kg every 12 hours) |
In invasive forms. The treatment reduces duration of illness, but does not prevent complications |
| Vibrio cholerae | – Cephalosporins III (ceftriaxone 50 mg/kg IV every 24 hours) – Ciprofloxacin (250–350 mg every 12 hours) |
The treatment reduces duration of illness and prevents dehydration. The antimicrobial susceptibility patterns are constantly changing |
| Yersinia spp | – Cephalosporins III (ceftriaxone 50 mg/kg IV every 24 hours) – Aminoglycosides (gentamicin 4 mg/kg IV every 24 hours) – Meropenem (20 mg/kg IV every 8 hours) – Ciprofloxacin (250–350 mg every 12 hours) |
Only in complicated cases |
Abbreviations: OS, orally; IV, intravenous; ETEC, Enterotoxigenic E. coli; EPEC, Enteropathogenic E. coli; EAEC, Enteroaggregative E. coli; EHEC, Enterohemorrhagic E. coli.