gastrointestinal disorders
Norovirus Gastroenteritis
Treatment of Norovirus Gastroenteritis
Oral or IV fluids Sometimes antidiarrheal agents and/or antiemetics Supportive care, including rehydration with fluids and electrolytes, is the mainstay of treatment and is all that is needed for most adults. Oral glucose-electrolyte solutions, broth, or bouillon may prevent dehydration or treat mild dehydration. Children may become dehydrated more quickly and should be given an appropriate oral rehydration solution (several are available commercially—see Oral Rehydration ). An antiemetic (eg, Isotonic IV fluids such as Ringer’s lactate and normal saline solution should be given when there is severe dehydration, hypovolemic shock, or altered mental status and ileus or failure of oral rehydration therapy (see also the Infectious Diseases Society of America's [IDSA]2017 clinical practice guidelines for the diagnosis and management of infectious diarrhea). In severe dehydration, IV rehydration should be continued until pulse, perfusion, and mental status normalize. Antidiarrheal agentsshould not be given to children < 18 years of age with acute diarrhea (see the IDSAguidelines). Antidiarrheals can be considered in adult patients with watery diarrhea (as shown by heme-negative stool), especially during an outbreak, suggesting a viral cause is likely. However, antidiarrheals may cause deterioration of patients withClostridioides difficileorE. coliO157:H7 infection and thus should not be given to any patients in whom the cause of diarrhea has not been identified and in whom these disorders may be suspected (ie, based on recent antibiotic use, bloody diarrhea, heme-positive stool, or diarrhea with fever). 