28th July 2023

Management

Most cases of acute bacterial gastroenteritis are self-limiting and do not require antibiotics. Those at the extremes of age, with prolonged symptoms, or the immunocompromised may require treatment. Ciprofloxacin is a reasonable choice of antibiotic in most cases, although there are increasing reports of resistance in imported diseases such as Shigella. Azithromycin is another option.

Whilst gastroenteritis is usually caused by an exogenous microorganism, other gastrointestinal infections are often caused by displaced bacteria from the usual GI tract flora. This is seen in biliary tract infections, such as cholecystitis, cholangitis and liver abscesses, peritonitis, and bowel perforation. As such, these infections are usually polymicrobial, and organisms such as Escherichia coli Klebsiella pneumoniae, Enterococcus and anaerobes are often found on specimen cultures. An empirical combination of cefuroxime and metronidazole is used to treat suspected intra abdominal infection until sensitivities are available.

More information about other abdominal infections, such as those of the liver, gallbladder and pancreas, can be found in the Hepatic Pathology and Pancreatico-biliary Pathology sections.