title: [Drug therapy of infectious diarrhea: part 1: acute diarrhea].
abstract: BACKGROUND
  Diarrhea is one of the most commonly occurring diseases.
  
  
  OBJECTIVE
  This article gives a review of the current state of the treatment of acute infectious diarrhea (part 1) and chronic infectious diarrhea (part 2) as well as of the most important pathogens.
  
  
  METHODS
  Following a presentation of the general principles of the therapy of diarrhea, the targeted antimicrobial therapy of the most important bacterial gastrointestinal infections is described. This includes salmonellosis, shigellosis and Campylobacter infections, infections with pathogenic Escherichia coli strains, yersiniosis and cholera. Due to the increasing incidence and changes in the severity of the disease and important new aspects in the treatment of diarrhea caused by toxigenic Clostridium difficile strains, these disease entities will be described in detail.
  
  
  RESULTS
  Symptomatic therapy is still the most important aspect of the treatment of infectious diarrhea. For severely ill patients with a high frequency of stools (> 8/day), immunodeficiency, advanced age or significant comorbidities, empirical antibiotic therapy should be considered. Increasing resistance, in particular against fluoroquinolones must also be taken into consideration. Due to the risk of excessive pathogen proliferation and concomitant intestinal toxin production with protracted or multiple complications during the disease, therapy with motility inhibitors is not recommended. With respect to the treatment of Clostridium difficile infections a promising novel aspect arose in 2012. The macrocyclic antibiotic fidaxomycin can reduce the rate of recurrent disease with the same effectiveness as vancomycin. Furthermore, evidence for the benefits of allogenic stool transplantation is increasing.
  
  
  CONCLUSIONS
  The treatment of acute diarrhea is still primarily supportive. The benefits of general empirical antibiotic therapy for acute diarrhea are not evidence-based.
authors: Fachbereich Infektions- und Tropenmedizin, Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig AöR, Liebigstr. 20, 04103, Leipzig, Deutschland, christoph.luebbert@medizin.uni-leipzig.de.
authors: C
authors: C
authors: Lübbert
authors: S
authors: S
authors: Weis
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000930:Antidiarrheals / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D004403:Dysentery / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents; D000930:Antidiarrheals
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