Antibiotic agents for empiric treatment of adults with acute diarrhea in resource-rich settings

Agent	Patients with watery (nonbloody) diarrhea	Patients with dysentery (diarrhea with visible blood or mucus)
Azithromycin	500 mg orally once daily for three days or 1 g (single dose); may divide in two equal doses to reduce nausea*	500 mg orally once daily for three days
Ciprofloxacin	500 mg orally twice daily for three to five days or 750 mg (single dose)*	500 mg orally twice daily for three to five days
Levofloxacin	500 mg orally once daily for three to five days or 500 mg (single dose)*	500 mg orally once daily for three to five days

Refer to UpToDate text for discussion of indications for empiric antibiotic therapy. Antibiotics may be combined with loperamide (first dose 4 mg, and then 2 mg dose after each loose stool; not to exceed 16 mg in a 24-hour period).

* If symptoms persist 24 hours after single-dose regimen, complete a three-day course using multiple-dose regimen.

Data from:

Riddle MS, DuPont HL, Connor BA. ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Acute Diarrheal Infections in Adults. Am J Gastroenterol 2016; 111:602.

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Antibiotic agents for empiric treatment of adults with acute diarrhea in resource-rich settings