diarrhea

IDSA Guidelines For Optimal Care of Patients with Infectious Diarrhea

Consulting an infectious disease specialist is recommended for primary care physicians who use a new culture-independent molecular test to diagnosis patients with infectious diarrhea, according to the new Infectious Diseases Society of America guidelines.

Culture-independent tests, which were developed in the last several years, can detect multiple organisms, some of which may be somewhat unfamiliar to primary care physicians. For cases like this, the guidelines recommend consulting an infectious disease specialists to interpret the clinical significance of the findings and facilitate appropriate public health surveillance.
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The new recommendations are an updated version of the 2001 guidelines and are designed to guide primary care physicians and other healthcare providers on the appropriate tests and treatment for patients who present with diarrhea symptoms.

Among the recommendations:

  • Children younger than 5, the elderly, people who are immune-compromised, those with bloody diarrhea, and patients presenting with severe abdominal pain or tenderness or signs of sepsis should be tested with the new culture-independent molecular test.
  • The majority of patients presenting with diarrhea, excluding the list above, do not require molecular testing.
  • Children with mild to moderate dehydration and adults and children with acute diarrhea and/or mild to moderate dehydration should be given rehydration solution, either orally or intravenously depending on the condition of the patient.

In addition, the guidelines include 7 tables that can used to quickly reference information on various ways patients acquire microbes, exposure conditions, post-infectious symptoms and clinical presentations, when to test patients, treatment considerations, and recommended antimicrobial, fluid and nutritional management.

The authors of the guidelines noted the importance of primary care physicians in identifying infectious diarrhea, stating: “We need the frontline clinicians to be astute and notice if they are seeing patients with an unusual infection, or a number of similar infections from a specific location such as a child care center, nursing home or eating facility and then work closely with the state and local health authorities.”

“This is the optimal way to develop community awareness and use an integrated approach to identify and contain an outbreak.”

—Melissa Weiss

Reference:

IDSA Infectious Diarrhea Guidelines recommend when to test, when to treat, when to notify public health officials [press release]. Arlington, VA: Infectious Diseases Society of America; October 19, 2017. http://www.idsociety.org/News_and_Publications/IDSA_News_Releases/2017/Pages/NEW_MOLECULAR_TESTING_FOR_INFECTIOUS_DIARRHEA_IMPROVES_DIAGNOSIS.aspx. Accessed October 19, 2017.