An audit of the clinical features and use of antimicrobials in adult diarrhoea.
We reviewed the case records of 128 adult patients hospitalized with diarrhoea. A relevant stool pathogen was isolated from 45, a diagnosis of culture-negative or non-specific gastroenteritis (NSGE) was made in 40 and the remaining 43 patients had no enteric infection. A history of fever or bloody stools was more common in those with culture-positive gastroenteritis than it was in those with NSGE or other diarrhoeal illness. The mean duration of diarrhoea prior to admission was significantly shorter in those with all forms of gastroenteritis than it was in the remainder. Epirical treatment with ciprofloxacin was commenced in 46% of all cases of gastroenteritis, of which 51% were found to have a relevant pathogen on stool culture. Patients with NSGE were just as likely to be treated with ciprofloxacin as those who were subsequently found to have culture-positive gastroenteritis. A history of abdominal tenderness or bloody stools did not discriminate for treatment with empirical ciprofloxacin in any patient group. Patients with positive stool cultures were more likely to be given ciprofloxacin if they were febrile but the same was not true for the other patients. In the patients reviewed, a significantly higher proportion of those with culture-positive diarrhoea presented with a history of fever or bloody stools. Despite this, the empirical use of ciprofloxacin in suspected infective gastroenteritis appeared to be only partially guided by the clinical features.
Laing
R B
RB
Reginal Infectious Diseases Unit, City Hospital, Edinburgh, U.K.
Lee
C
C
Leen
C L
CL
D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000627:therapeutic use*; D003967:Diarrhea / Q000188:drug therapy* / Q000382:microbiology; D004363:Drug Utilization; D005243:Feces / Q000382:microbiology; D005759:Gastroenteritis / Q000150:complications*; D006801:Humans; D012606:Scotland
D000890:Anti-Infective Agents; D002939:Ciprofloxacin