Butzler J P
Schweiz Med Wochenschr Suppl. 1984;17:29-34.
Since dehydration is the most frequent complication of acute diarrhoea, fluid and electrolyte repletion are the most important components of treatment. In mild diarrhoea and cases where the etiologic agent is unknown there is no need for antimicrobial chemotherapy. Indeed the benefit of an antibiotic has never been proven in these cases. Moreover side effects can occur: change in gut flora causing chronic diarrhoea, selection of drug-resistant strains, pseudomembranous colitis, toxicity of the drug. Antibiotics are often useless because a large number of diarrhoeal illnesses are caused by viruses or are of nonmicrobial origin (Rotaviruses may be responsible for up to 60% of winterdiarrhoea in children). When the diagnosis is in doubt between a primary bowel infection and a septicaemic illness antibiotic therapy is of course fully justified.
由于脱水是急性腹泻最常见的并发症，补充液体和电解质是治疗的最重要组成部分。在轻度腹泻以及病因不明的情况下，无需进行抗菌化疗。事实上，抗生素在这些情况下的益处从未得到证实。此外，还可能出现副作用：肠道菌群改变导致慢性腹泻、耐药菌株的产生、伪膜性结肠炎、药物毒性。抗生素往往无效，因为大量腹泻疾病是由病毒引起的或源于非微生物因素（轮状病毒可能导致儿童冬季腹泻的比例高达60%）。当原发性肠道感染和败血症性疾病的诊断存在疑问时，抗生素治疗当然是完全合理的。
