Vomiting & Diarrhoea in a nursing home - Rcpa.tv

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The previous question demonstrates one of the conudrums with microbiology diagnosis of gastroenteritis. The list of pathogens be they viral or bacterial, increases each year, yet an ordinary laboratory has finite resources to investigate any particular episode of gastroenteritis. More importantly, many episodes of diarrhoea are self limited and do not require diagnosis, and many doctors will not send a faecal specimen to the laboratory in the setting of the initial presentation of acute diarrhoea, but concentrate on symptomatic support. Current technology does not allow cost effective detection of all the described pathogens, and as some of the pathogens are also colonisers, clinical input into test selection and interpretation is critical. The next section introduces with some prophylaxis and therapy issues
Prevention of travellers diarrhoea The oral cholera vaccine has been shown to be an effective vaccine against travellers diarrhoea. Interestingly, the vaccine overseas has been direct marketed to the travel industry, and is quoted as direct marketing success story. This does not detract from the vaccine but is an example of competing interests having differing points of view. There are often conflicts between medicine and commercial interests, and one of the reasons behind increasing drug resistance in a number of common intestinal bacterial pathogens, such as campylobacter and salmonella, has been the use of antimicrobials in animal Feed. Antibiotics as well are available, to protect against travellers diarrhoea, and the pro’s and cons are well covered in recent antibiotic guideline reviews. Dukoral abstract
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Page 23 and 24: Antibiotic resistance: recent abstr
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Vomiting & Diarrhoea in a nursing home - Rcpa.tv

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