Here in the Badger Sett we have a useful guideline developed by a GP 
gastroenterologist and her pal a distinguished paediatric 
gastroenterologist which says for community acquired diarrhoea if >4 
stools a day for > 3 days Rx ciprofloxacin 500mg bd x 3 days. Of course 
there is more to it than that and if bloody diarrhoea + patient not ill 
enough to need hospitalisation / diagnosis not in doubt they will often 
get the same at an earlier stage. This bit of worked changed my practice.

Of course there is more to it than that. However most D&V is now managed 
primarily by telephone with only certain people being seen for physical 
examination. We have no access out of hours to investigations so it is 
all clinical skills and no clever stuff or technology.

My gastro mate says the guidelines need to be amended to take account of 
some point of detail in the latest research. We copyrighted them but as 
an organisation we are rubbish at writing up the masses of things we do 
so never been published apart from internal use.

Best wishes
Fay



Marcus Hawkins wrote:
> Here we go with an "old cherry'. To treat or not to treat?
> Tis the season for lots of cooked fowl (& BBQs down here in New Zealand). 
> Seeing a lot of diarrhoea & sometimes the working diagnosis is 
> campylobacter. Some treat with antibiotics automatically & some do not.
> I know that there are guidelines on such matters but I am also interested 
> in anecdotal experience.
> What do members of the list think about the use of antibiotics in 
> campylobacter per se & in the setting of post Xmas/BBQ diarrhoea.
>
> Marcus
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