In this article, we will discuss the Management of Bacterial Food Poisoning. So, let’s get started.
Management
It is an emergency. Patient needs replacement of fluids and electrolytes to prevent the development of peripheral circulatory failure. The steps of management include:
1. Fluid and electrolytes: The patient should be given fluids (ORS) to compensate the fluid loss in the stools and to correct dehydration which is commonly present in these cases. Patient with severe dehydration should receive I.V. fluids such as Ringer’s lactate. The pulse, BP, temperature and urinary output should be monitored. The electrolytes should be monitored and corrected accordingly.
2. Antibiotics: Specific treatment of bacterial diarrhoea includes oxytetracycline (500 mg after every 6 hours) for shigellae infection and ciprofloxacin 500 mg bid or bismuth subsalicylate (2 tab after half an hour intervals up to 8 doses) for E. coli, Salmonella or other bacterial diarrhoea. Metronidazole 400–800 mg tid is effective against anaerobes.
Conventionally, it is better to start
with ciprofloxacin plus metronidazole
in such an acute situation so as to cover most of the causative organisms till a final report of stool culture is received. Parenteral antibiotic therapy is indicated if patient is not accepting orally. The treatment is continued for few days. Depending on the response, most of the patients show rapid recovery.
3. Anticholinergic and antimotility: Drugs have no role. However, loperamide has been used to reduce the frequency of stool. It is given 4 mg initially followed by 2 mg with each stock (maximum 8-12 mg) in E. coli induced food poisoning,