Will antibiotics help diarrhea improve quickly? Risks explained

Authors: Yu J, Jing H, Lai S; Reviewers: Wang LP, Zhou SX; Curator: Kim YJ; Production Information: J Infect, Nat Commun, Infect Chemother.

Will antibiotics help diarrhea improve quickly? Risks explained.

If I have diarrhea, can I take antibiotics to get better fast?

There is no scientific basis for this claim.

Most diarrhea is not caused by bacterial infections, and indiscriminate use of antibiotics is not only ineffective but also harmful.

Many people mistakenly believe that diarrhea is due to bacterial infection, leading them to habitually seek antibiotics in order to 'sterilize and stop diarrhea.' However, the actual causes are much more complex.

According to China's five-year multi-center surveillance data, only about 13% of diarrhea cases in children under five years of age were found to contain pathogenic bacteria such as Escherichia coli, Salmonella, and Shigella, with viral infections being the predominant cause. Among these, rotavirus accounted for nearly 30%, and norovirus also exceeded 11%. Surveillance results across all age groups revealed a similar trend, primarily indicating viral infections. Antibiotics are ineffective against these viral types of diarrhea, and misuse can damage the gut microbiota, prolong disease duration, and increase the risk of drug resistance.

Even when a bacterial infection is diagnosed, not all cases require antibiotics. Acute gastroenteritis is largely a self-limiting disease, and antibiotics are not considered first-line treatments. The use of antimicrobials should only be considered if severe watery stools are accompanied by fever, bloody stools, or dehydration, or if there is a confirmed diagnosis of infection caused by pathogenic Escherichia coli, Shigella, or Salmonella. It is recommended to use antibiotics judiciously under medical guidance.

What is even more alarming is that children have immature immune systems, and excessive use of antibiotics introduces additional risks, including imbalances in gut microbiota, allergic reactions, and the emergence of potentially drug-resistant strains. Future infections may occur with 'no effective treatments available.'

Therefore, diarrhea does not equate to taking antibiotics, and seeking 'quick relief of diarrhea' may instead lead to chronic health issues. It is essential to properly identify the cause, ensure adequate hydration, and determine whether medical attention is needed based on the severity of the symptoms. Antibiotics should be used judiciously and never when they are unnecessary. This approach is the most reliable way to protect your child's health.

Reference materials:

1. Yu J, Jing H, Lai S, et al. Etiology of diarrhea among children under the age of five in China: Results from a five-year surveillance. J Infect. 2015;71(1):19-27.

2. Wang LP, Zhou SX, Wang X, et al. Etiological, epidemiological, and clinical features of acute diarrhea in China. Nat Commun. 2021;12(1):2464.

3. Kim YJ, Park KH, Park DA, et al. Guidelines for the Antibiotic Use in Acute Gastroenteritis. Infect Chemother. 2019;51(2):217-243.