Most foodborne illness is viral or self-limiting bacterial gastroenteritis and settles with oral rehydration. Stool testing and antibiotics are for the minority: bloody diarrhoea, high fever, severe dehydration, symptoms lasting more than a week, the immunocompromised, the very old and pregnant women (where Listeria matters). Avoid antibiotics when bloody diarrhoea could be Shiga toxin-producing E. coli, as they may raise the risk of haemolytic uraemic syndrome in children. Clusters of cases after a shared meal should be notified to public health.
- Start with oral rehydration solution; most cases need nothing more.
- Send stool culture for bloody diarrhoea, high fever, severe illness or symptoms beyond a week.
- Be cautious with antibiotics in bloody diarrhoea in children until STEC is excluded.
- Ask pregnant women about soft cheeses and unpasteurised foods — Listeria can present as a mild flu-like illness.
- Report suspected outbreaks to the local health authority.
Why it matters
Routine antibiotics for food poisoning add side-effects and resistance with little benefit.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for family medicine, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free