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Do not prescribe antibiotics or antiprotozoals for acute non-dysenteric diarrhoea or gastroenteritis when there is no fever and no blood in the stool. Setting: acute non-dysenteric diarrhoea or gastroenteritis with no fever and no blood in stool Why: Most acute watery diarrhoea is viral and self-limited; empiric antibiotic-antiprotozoal combinations (e.g. fluoroquinolone + nitroimidazole) do not shorten the illness and drive antimicrobial resistance and adverse effects. Consider instead: oral rehydration and symptomatic care; reassess if fever, blood in stool, or dehydration develops Source: Indian Council of Medical Research (AMR guidelines) (guideline-derived, IN, 2019).
Do not start empiric antibiotics for acute undifferentiated fever of less than 5 days without a localising source or red flags. Setting: acute undifferentiated fever of less than 5 days duration with no localising source on history and examination and no red flags (haemodynamic instability, altered sensorium, severe dehydration, immunocompromise) Why: Acute undifferentiated short-duration fever in the outpatient setting is most often viral or vector-borne, where empiric antibacterials do not help; they add adverse effects and drive resistance (WHO AWaRe stewardship). Consider instead: symptomatic treatment, hydration, and planned review; targeted testing (e.g. malaria smear, dengue serology as locally indicated) before any antimicrobial Source: Indian Council of Medical Research (AMR guidelines) (guideline-derived, IN, 2019).
Do not prescribe antibiotics or antiprotozoals for acute non-dysenteric diarrhoea or gastroenteritis when there is no fever and no blood in the stool. Setting: acute non-dysenteric diarrhoea or gastroenteritis with no fever and no blood in stool Why: Most acute watery diarrhoea is viral and self-limited; empiric antibiotic-antiprotozoal combinations (e.g. fluoroquinolone + nitroimidazole) do not shorten the illness and drive antimicrobial resistance and adverse effects. Consider instead: oral rehydration and symptomatic care; reassess if fever, blood in stool, or dehydration develops Source: Indian Council of Medical Research (AMR guidelines) (guideline-derived, IN, 2022).
Do not start empiric antibiotics for acute undifferentiated fever of less than 5 days without a localising source or red flags. Setting: acute undifferentiated fever of less than 5 days duration with no localising source on history and examination and no red flags (haemodynamic instability, altered sensorium, severe dehydration, immunocompromise) Why: Acute undifferentiated short-duration fever in the outpatient setting is most often viral or vector-borne, where empiric antibacterials do not help; they add adverse effects and drive resistance (WHO AWaRe stewardship). Consider instead: symptomatic treatment, hydration, and planned review; targeted testing (e.g. malaria smear, dengue serology as locally indicated) before any antimicrobial Source: Indian Council of Medical Research (AMR guidelines) (guideline-derived, IN, 2022).