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Dx Gastro-intestinal Infection Treatment: Read more....

Gastro-Intestinal Infections

The Merck Manual Home Edition
"Giardiasis is an infection of the small intestine caused by the single-celled protozoan parasite Giardia lamblia.
*The main symptoms are abdominal cramping and diarrhea.
*People acquire the infection by drinking contaminated water or by having contact with contaminated stool.
*Doctors diagnose the infection by testing or examining a stool sample.
*Hikers should boil fresh water before drinking it. Giardiasis occurs worldwide and is the most common parasitic infection of the intestine in the United States. Giardia protozoa are a common contaminant of fresh water, including many lakes and streams—even ones that appear clean.
*If untreated, the diarrhea may persist for weeks.
*Some infected people have no symptoms. In other people, symptoms appear about 1 to 2 weeks after infection. Symptoms typically include abdominal cramps, gas (flatulence), belching, and watery, foul-smelling diarrhea. The symptoms often suggest the diagnosis.
*The easiest way to make the diagnosis is by testing the stool for proteins (antigens) released by Giardia lamblia.

*Tinidazole, taken in a single dose, has fewer side effects than
*metronidazole, which requires several doses. Drinking alcohol within a few days of taking tinidazole or metronidazole may cause nausea, vomiting, flushing, and headaches.
* Nitazoxanide is available in liquid form, which is useful for children, and as tablets. It has few side effects.Pregnant women should not take any of these medications.

Traveler's Diarrhea
Traveler's diarrhea is usually due to a type of Escherichia Coli (E. coli). Traveler's can get this from brushing their teeth, ice cubes or eating food washed in contaminated water. Diarrhea, vomiting, headache and muscle pain ay imply the norovirus instead. Diagnostic tests are rarely needed.
Medical treatment is supportive with copious amounts of fluid and loperamide to slow down the diarrhea. Antibiotic recommendations include ciprofloxacin, levofloxacin, azithromycin or rifaximin.

Campylobacter infections are among the most common bacterial infections, producing both diarrhea and systemic disease. the stool may be bloody to dysenteric. The bacteria is related to Helicobacter pylori, so many antibiotics including Bactrim DS for two (2) weeks should be curative.

Medications used in Treatment:
1. Antifolate/Sulfa Antibiotic Combinations: Bactrim® Septra® Sulfatrim®/sulfamethoxazole-trimethaprim
2. Nitroimidazole: Flagyl®/metronidazole
3. Penicillins: Amoxil®/ampicillin
4. Glycopeptides: vancomycin, Vancocin®/vancomycin
5. Cephalosporins: Rocephin®/ceftriaxone
6. Penem: Invanz/ Vancocin®/ vancomycin/ ertapenem, MerremVancocin®/vancomycin/meropenem
7. Monobactam: Azactam®/aztreonam

*[Editor] When traveling to less developed areas, having these medications makes sense: Lomotil, Atarax, Ciprofloxacin, Flagyl, Azithromycin, Bactrim DS.

*[Editor] A result of antibiotic use may be the difficult to treat Clostridium difficile infection(CDI). First treatment is the antibiotic vancomycin. Sha reports "Although more controlled trials are needed, faecal microbiota transplantation therapy shows promise in both adults and children with gastrointestinal diseases such as CDI and Inflammatory Bowel Disease(IBD).

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