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Questions and Answers
What is the primary reason for preferring macrolides over fluoroquinolones for treating Campylobacter?
Why should antibiotics be avoided in patients with E. coli 0157:H7?
What is the primary treatment for Scombroid poisoning?
What is the primary advantage of tinidazole over metronidazole for treating Giardia?
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What is the most effective therapy for Cryptosporidiosis?
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What is the primary consideration in evaluating a patient with chronic diarrhea (>4 weeks)?
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Study Notes
Antibiotic Treatment for Bacterial Infections
- Macrolides are the preferred antibiotics for treating Campylobacter infections due to increasing resistance to fluoroquinolones.
- Antibiotics should not be given to patients with E. coli 0157:H7, as this can trigger Hemolytic Uremic Syndrome (HUS).
Treatment for Food Poisoning
- Scombroid poisoning is treated with antihistamines, such as diphenhydramine.
Treatment for Parasitic Infections
- Giardiasis is primarily treated with metronidazole.
- Tinidazole is a newer agent for treating Giardiasis, effective in a single dose.
- Cryptosporidiosis is treated with nitazoxanide, although its efficacy is limited.
- The most effective therapy for cryptosporidiosis is to increase the CD4 count to >100/mm3 using antiretrovirals.
Management of Viral Diarrhea
- There is no specific therapy for viral diarrhea.
- Patients are managed with fluid and electrolyte support until the infection resolves.
Differential Diagnosis for Chronic Diarrhea
- Consider the use of artificial sweeteners (get diet history) in patients with chronic diarrhea (>4 weeks).
- Giardiasis is a possible cause if the patient has been camping or exposed to children (e.g., daycare worker).
- If bloating and discomfort are relieved by bowel movement with no weight loss, consider Irritable Bowel Syndrome (IBS) and test for celiac disease.
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Description
This quiz covers the antibiotics and treatments for various gastrointestinal infections, including Campylobacter, E. coli, Scombroid poisoning, Giardia, and Cryptosporidiosis.
