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  • Rounds
  • Management of watery loose motion for 13 yr old boy. Patient already taken Ofloxacin+Ornidazole/Norfloxacin+Tinidazole, Pre and Probiotic Cap, Loperamide, ORS etc in different doses.
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Verified response May I respectfulky ask why so many antibiotics & antimotiity agents [BOTH CONTRAINDICATED if this is ENTEROHEMORRHAGIC E. COLI related] --- ie EHEC 0157:H7 Shiga toxin producing; less frequently being related to Shigella dysenteriae type1 or Salmonella infections. We know that in STEC:E Coli infections, that both ANTIMOTILITY & antimicrobial agents can increase by factor of 25% the evolution of HUS[Hemolytic Uremic Syndrome] --- which is most common reason for ARF in children. Unless you have a presumed BACTERIOLOGIC DX, would withdraw antibiotics, & send stool WBC & for C Difficile antigen x 3. Monitor electrolytes, RFTs, CBC & hydrate appropriately.
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@Estrella Maria Rita Martinez Md: Respected Mam, 1st day he taken Norfloxacin+Tinidazole and 2nd day he had taken Ofloxacin+Ornidazole with pre and pro biotic
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Neeraj: I understand, & when it comes to a precious child, the impulse is always to do "something" --- but in our armentarium, we can oftentimes do more harm than good --- especially using antibacterial agents in the absence of a clear diagnosis. Need to establish the etiology of this child's diarrhea, as continuing the above agents can contribute to HUS, Toxic megacolon, & even to C.difficile colitis. Further, as far as I know, no proven benefit to probiotics in acute diarrhea. I will post helpful diagnostic algorithms....Blessings to you.
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@Estrella Maria Rita Martinez Md:in acute diarrhoea our body tries to eliminate harmful toxins and food. by supressing the stool in acute phase,this process is stopped which may cause statis and further gut disurbance. i fully concur with you mam. most of the cases recover in 24 hrs. remaining can be kept in observation. fasting and bulk forming foods are sufficient to improve.
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zinc and ORS are sufficient for initial management of diarrhoea
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Most diarrhea in children is due to viral infection eg rotavirus. Unless evidence of bacterial infection: Hydration- Iv fluids or ors depending on level of dehydration. Zinc sulphate for 10-14 days.
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