In cases of inflammatory diarrhea, when are antibiotics generally indicated?

Antibiotics are indicated in cases of inflammatory diarrhea when there is a high risk of complications, particularly in vulnerable populations such as very young children and elderly patients. These groups often have weaker immune systems and are more susceptible to the severe consequences of diarrhea and dehydration. Inflammatory diarrhea can be caused by bacterial infections, such as those from Shigella or certain strains of E. coli, where antibiotics may help reduce the duration and severity of illness.

In contrast, in otherwise healthy adults, using antibiotics indiscriminately can lead to issues like antibiotic resistance and potentially worsen the condition by disrupting the normal gut flora. Similarly, in older children and adults who are not in high-risk categories, supportive care with hydration is typically sufficient. Therefore, the targeted use of antibiotics in specific vulnerable populations aligns with best practices in managing inflammatory diarrhea, as these populations stand to benefit the most from early intervention to prevent complications.