Antibiotics for GI Infections

On occasion there may be specific indications to treat infectious diarrhoea.

Salmonella are a species of facultative intracellular pathogens, which infect patients eating contaminated food. Infections can be classified as non typhoidal or typhoidal. Non typhoidal  infection may be limited to the gut, where release of endotoxins (poisoins from inside the bacteria that only cause disease when the cell dies) cause gastrointestinal upset, or be more invasive which cause systemic upset, through the release of endotoxins by bacteria when they die. Invasive nontyphoidal salmonella carries a considerable risk of mortality (perhaps 20-30%). Bacteria from typhoidal strains only infect higher apes and may cause non-invasive, or invasive disease, otherwise known as typhoid fever. In general only invasive forms of Salmonella, often infrail or immune-compromised patients require specific antibiotic treatment. There is evidence that treatment of non-invasive forms which ony cause gastrointestinal upset my prolong illness and promote carriage of the organism going forward.

Similarly Campylobacter infection is usually self limiting, but may require specfic treatment in the frail or immunocompromised..

For patients who contract E.coli 0157 antibiotics are not recommended in the great majority of cases because they may lead to sudden endo-toxin release and multi-organ failure in vulnerable individuals,.