PAS, FQs, Eto or Pto, Amx/Clv, Ipm/Cln or Mpm
Diarrhoea, along with cramping, can cause significant difficulty and lead to discontinuation of treatment.
PAS often causes diarrhoea at treatment initiation. It usually resolves or improves substantially after some weeks.
For diarrhoea with no blood in stools and no fever, loperamide PO (adult: 4 mg followed by 2 mg after each loose stool to a maximum of 10 mg daily) may be used intermittently, especially when the patient needs to attend social functions or return to work, but not on a daily basis.
Encourage the patient to tolerate some degree of diarrhoea. Prevent (encourage fluid intake including oral rehydration solution) or treat dehydration.
In the event of severe diarrhoea, particularly if associated with blood in stools, severe abdominal pain, or fever > 38.5 °C, consider other causes such as acute bacterial enteritis, or pseudo-membranous colitis (C. difficile) due to FQs. Do not use loperamide for bloody diarrhoea or diarrhoea associated with fever.
Monitor serum electrolytes in patients with severe diarrhoea taking QT prolonging drugs.