Gastroenteritis is most often viral in origin and Rotavirus and Norovirus most frequently implicated in young children. Stool-based multiplex Polymerase Chain Reaction (PCR) can detect bacteria, viruses or parasites that may or may not be responsible for
gastroenteritis (colonization). While the etiological profile of these digestive
infections has greatly benefited from PCR, in the absence of underlying pathologies the presence of potential pathogens does not justify anti-infectious treatment. Indeed, very few bacterial causes require
antibiotic treatment, apart from
shigellosis, severe forms of
salmonellosis and a few Campylobacter sp.
infections. The development of antibiotic resistance in Salmonella sp., Shigella sp. and Campylobacter sp. is a cause for concern worldwide, limiting therapeutic options. The
antibiotics proposed in this guide are in line with the joint recommendations of the European Society of Pediatric
Infectious Diseases and the European Society of Pediatric Gastroenterology and Nutrition.
Azithromycin is preferentially used to treat
infections with Shigella sp. or Campylobacter sp.
Ceftriaxone and
ciprofloxacin are recommended for
salmonellosis requiring
antibiotic therapy. Empirical treatments without bacterial identification are not indicated except in cases of
severe sepsis or in subjects at risk (e.g.,
sickle-cell disease).
Metronidazole should be prescribed only for acute
intestinal amebiasis after microbiological confirmation.