Nondysenteric Diarrhea (other than C. difficile)

Diagnosis Common Pathogens Drug(s) of First Choice Alternative Drug(s) Comments Expected Duration

Large volume, nonbloody, watery diarrhea.

Patient may have nausea, vomiting, and abdominal cramping but fever often absent

Viruses

Giardia

Enterotoxigenic E. coli

Enterotoxin-producing bacteria

Clostridium difficile

General Care: Observation

Oral rehydration

Antimotility agents (do not use in C. difficile infection)

 

Generally, empiric therapy and stool cultures are not indicated. Most disease is self-limiting and can be treated with antimotility agents.

If patient fails to improve, cultures are negative, and symptoms persist, consider stool for O & P

Check C. difficile toxin, especially if recent history of antibiotic use or hospitalization.

No antibiotic therapy indicated except for C. difficile

Clinical Infectious Diseases, Volume 65, Issue 12, 29 November 2017, Pages e45–e80, https://doi.org/10.1093/cid/cix669