gastrointestinal disorders
E. coli Gastroenteritis
Treatment ofE. coliGastroenteritis
Oral or IV rehydration Sometimes antibiotics 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 rehydration solution (several are available commercially—see Oral Rehydration ). Isotonic IV fluids such as Ringer’s lactate and normal saline solution should be given when there is severe dehydration, shock, or altered mental status and ileus or failure of oral rehydration therapy (see also the Infectious Diseases Society of America's [IDSA] Antidiarrheal agents(eg,loperamide) should not be given to children < 18 years of age with acute diarrhea (see the IDSAguidelines). Antidiarrheals are generally safe for adult patients with watery diarrhea (as shown by heme-negative stool). However, antidiarrheals may cause deterioration of patients withClostridioides difficileorE. coliO157:H7 infection and thus should not be given to any patients with recent antibiotic use, bloody diarrhea, heme-positive stool, or diarrhea with fever, pending specific diagnosis. infection is high (eg, contact with a known case). Otherwise, antibiotics should not be given until stool culture results are known because antibiotics increase the risk of Hemolytic-Uremic Syndrome (HUS) in patients infected with The use of probiotics is not recommended for suspectedE. coligastroenteritis (see also the American College of Gastroenterology's2016 clinical guideline of the diagnosis, treatment, and prevention of acute diarrheal infections in adultsand the American Gastroenterological Association's2020 clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders). 