Extract from Clinical Evidence: Diarrhoea

Abstract

Interventions Trade off between benefits and harms Empirical antibiotic treatment in travellers' diarrhoea Empirical antibiotic treatment in community acquired diarrhoea Summary points RCTs have found that empirically treating travellers' diarrhoea with antibiotics reduces the length of illness by one to two days. In community acquired diarrhoea, RCTs have found that ciprofloxacin reduces the duration of diarrhoea by one to two days. Trials of other antibiotics have found no evidence of benefit or have not reported on time to cure. Some RCTs found that treatment prolonged excretion of organisms and was associated with the development of resistant organisms. ### Definition Diarrhoea is defined as watery or liquid stools, usually with an increase in stool weight above 200 g per day and an increase in daily stool frequency. Incidence/prevalence An estimated 4000 million cases of diarrhoea occurred worldwide in 1996, resulting in 2.5 million deaths.1 In developing countries, diarrhoea is reported to cause more deaths in children aged under five years than any other condition.1 In the United States, which has a low incidence, the estimated incidence for infectious intestinal disease is 0.44 episodes per person per year, or one episode per person every 2.3 years, resulting in about one consultation with a doctor per person every 28 years.2 The epidemiology of travellers' diarrhoea (people who have crossed a national boundary) is not well known. Incidence is higher in travellers going to developing countries but varies widely by location and season of travel. 3 ### Aetiology The cause depends on geographic location, standards of food hygiene, sanitation, water supply, and …