Approach to the Patient With Infectious Colitis

Herbert L. DuPont


Curr Opin Gastroenterol. 2012;28(1):39-46. 

In This Article


Patients with infectious colitis usually will benefit by receiving an antimicrobial drug directed against the causative agent. Laboratory study will be important to identifying the cause of the colitis.

Nonspecific Treatment

Patients with infectious colitis such as others with diarrhea of small bowel origin will benefit by paying attention to fluid and salt administration to meet losses from illness and to keep up with continuing losses. Occasionally intravenous fluid administration will be needed. Symptomatic therapy with antimotility therapy (e.g., loperamide) is generally not indicated in infectious colitis and can be dangerous if given without specific treatment.[26] There is no evidence that the antimotility drugs are harmful in inflammatory diarrhea if given with proper antimicrobial treatment designed to treat the bacterial enteric infection.[27•,28] For possible STEC infection in which specific therapy is not available, antimotility drugs can potentiate the development of HUS.[29••]

Antimicrobial Therapy

In Table 2 recommended antimicrobial therapy for the various forms of infectious colitis are provided. Making an etiologic diagnosis (Table 1) is important for developing a plan for therapy.


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