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Diarrhoea - antibiotic associated - Management
Basis for recommendation
These recommendations are extrapolated from guidance issued by the Department of Health and the Health Protection Agency (HPA), and expert opinion on assessing people with acute diarrhoea and clinical features of Clostridium difficile infection [Bartlett, 2002; Starr, 2005; Bartlett and Gerding, 2008; DH and HPA, 2008; World Gastroenterology Organisation, 2008; Rupnik et al, 2009; Williams and Spencer, 2009].
Exclusion of other causes of diarrhoea and assessment for C. difficile infection
- The recommendations to exclude other causes of diarrhoea and to assess for C. difficile infection are consistent with guidance on C. difficile infection issued by the Department of Health and the HPA when managing suspected potentially infectious diarrhoea [DH and HPA, 2008].
- There are no specific clinical features for C. difficile infection and a number of disorders may have similar clinical presentation (for example infections by other enteric pathogens — see the section on Causes in the CKS topic on Gastroenteritis) [Bartlett and Gerding, 2008]. Diarrhoea with a foul-smelling odour is not sufficiently specific for a definitive diagnosis of C. difficile [Rupnik et al, 2009].
- Consequently, people with diarrhoea and appropriate risk factors should be assessed for C. difficile infection.
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