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We explore the clinical management of foodborne and waterborne illnesses, focusing on key differences between viral and bacterial causes that determine treatment approaches. Understanding when to use supportive care versus antimicrobial therapy helps clinicians provide appropriate management for this common presentation.

• The vast majority of diarrheal illnesses are viral, self-limited, and need no testing or treatment beyond oral rehydration
• Oral rehydration solutions are preferred over sports drinks, which can worsen diarrhea unless diluted
• Homemade solution can be made with half teaspoon salt, six teaspoons sugar, and one liter of water
• Anti-motility agents like loperamide should be avoided in children under two and patients with bloody diarrhea
• Bloody diarrhea with fever (dysentery syndrome) typically indicates bacterial causes like Salmonella, Shigella, E. coli O157:H7, or Campylobacter
• Azithromycin is now preferred over fluoroquinolones for treating bacterial diarrhea due to less resistance
• Antimicrobials should be avoided in children with suspected E. coli O157:H7 due to risk of hemolytic uremic syndrome

Watch for more detailed content on managing diarrheal illnesses in high-risk groups coming soon to the pit.