Hesperian Health Guides
Belly Pain, Diarrhea, and Worms: Medicines
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Medicines for Diarrhea
Rehydration is the most important treatment for diarrhea no matter what is causing it. In many cases, rehydration and food are all that is needed. When there is giardia, dysentery (amebas or shigella), or cholera, especially in young children and old people, antibiotics and other medicines may also be helpful.
Giardia
Metronidazole works best; give for 5 days. Quinacrine can also be used and may be cheaper.
Amebic dysentery
Use metronidazole for 7 to 10 days. Also use diloxanide.
Shigella
Shigella is resistant to several antibiotics, so it is very important to find out what medicines still work in your area. Try to find out what your local health authority recommends. You may be able to use ampicillin, or cotrimoxazole. But in many places there is resistance to these medicines, and ceftriaxone should be used instead. Ciprofloxacin can be used by adults, but avoid giving it to children. Whatever medicine you use, if there is no improvement after 2 days, change to a different antibiotic.
Cholera
Rehydration is essential to save the life of someone with cholera. Give rehydration drink constantly until the diarrhea has stopped and there are no more signs of dehydration. Then continue to give a cup of rehydration drink after every stool. Rehydration drink made with rice or maize meal may make it even more effective.
People with cholera or other severe cases of diarrhea should also be given zinc supplements.
Antibiotics are not the most effective treatment for cholera, and in most places cholera is resistant to several antibiotics. Only give antibiotics when you know which ones work against cholera in your area. Start antibiotics by mouth after the person stops vomiting. Antibiotics that may be helpful include doxycycline, tetracycline, cotrimoxazole, ciprofloxacin, and erythromycin. Erythromycin is the safest for pregnant women and children.
There are vaccines that can help prevent cholera. They work best when a whole community is given the vaccine to prevent the spread of an outbreak. Ask your local health authority to distribute this.