diarrhea

IDSA: New Diarrhea Guidelines Are the First Since 2001

The Infectious Diseases Society of America (IDSA) has issued new clinical practice guidelines for the diagnosis, management, and treatment of acute or persistent infectious diarrhea in children and adults.

The new guidelines, which were composed by an IDSA-assembled panel of experts, are the first to be published by the IDSA since 2001.
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The guidelines also briefly address the public health aspects of diarrhea associated with foodborne and waterborne diarrhea, international travel, antimicrobial agents, immunocompromised hosts, animal exposure, certain sexual practices, health-care–associated diarrheal infections, and infections acquired in childcare and long-term care facilities.

The following recommendations are included in the new guidelines:

  • A detailed clinical and exposure history should be obtained from individuals with diarrhea, under any circumstances, including when there is a history of similar illness in others (strong, moderate evidence).
     
  • People with diarrhea who attend or work in childcare centers, long-term care facilities, patient care, food service, or recreational water venues including pools and lakes should follow jurisdictional recommendations for outbreak reporting and infection control (strong, high evidence).
     
  • Individuals with fever or bloody diarrhea should be evaluated for enteropathogens for which antimicrobial agents may provide clinical benefit, including Salmonella enterica subspecies, Shigella, and Campylobacter (strong, low evidence).
     
  • Enteric fever should be considered when a febrile person (with or without diarrhea) has traveled to areas in which causative agents are endemic, has consumed foods prepared by people with recent endemic exposure, or has laboratory exposure to S enterica serovar Typhi or S enterica serovar Paratyphi (strong, moderate evidence).
     
  • Individuals of all ages with acute diarrhea should be evaluated for dehydration, which increases the risk of life-threatening illness and death, especially in youth and older adults (strong, high evidence).

The full version of the guidelines can be found in the November 2017 issue of Clinical Infectious Diseases.

—Christina Vogt

Reference:

Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017;65(12):1963-1973. https://doi.org/10.1093/cid/cix959.