Bacillary Dysentery (Bloody Diarrhoea)

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Always send stool for microscopy and culture to guide your antibiotic choice and to exclude amoebiasis. Empirical choice of antibiotic as below:

Rehydration as for gastro-enteritis (see main Zimbabwe STG).

	Medicine	Adult dose	Frequency	Duration
	nalidixic acid po	1gm	4 times a day	5 days
or	ciprofloxacin po	500mg	twice daily	5 days
or	ceftriaxone iv	1g	twice daily	5days

Avoid antimotility drugs. Persistent culture negative bloody diarrhoea beyond 6 weeks must be referred for evaluation for inflammatory bowel disease.