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Dr. K.
Dr. K., Board Certified MD
Category: Medical
Satisfied Customers: 8752
Experience:  Board certified with experience in primary care.
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My 14 month son has severe bloody diarrhea, fever and

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Hello, my 14 month son has severe bloody diarrhea, fever and stomach cramps for 4 days. The bacteria results are not back for a few days. He is in hospital now with suspected dissentry and is getting worse not better on Ceftriaxone. My wife is distraught in tears. She is a doctor and did not want this anti biotic due to the side effects and he seemed to be responding well to gentamicin
JA: How long has this been bothering you? Are you experiencing any vomiting or nausea?
Customer: My son has not vomited
JA: Is there anything else the Expert should know before I connect you? Rest assured that they'll be able to help you.
Customer: What are the costs for this, I have not used this site before. My wife is in tears and I cannot be with here due to hospital covid regulations.
Customer: replied 16 days ago.
Here is his latest stool. His mood was happy until yesterday. My mother in law, also a doctor panicked and took him to hospital. While in the ER he could not rest or be hydrated, was scared and his condition worsened. He was not like this other days and my wife severely regrets this decision, as he was responding to treatment before and now they have changed it. Medicine is not my field and we would like a second opinion, as my wife does not have confidence in those in charge.
Customer: replied 16 days ago.
The WHO recommends this treatment for dissentry but the NHS and other pediatricians advise it is better to let children's immune system fight it, so we are a a little torn

Hello and welcome to Just Answer. I am Dr K. I have over 25 years of clinical experience and look forward to answering your question. i may need more information from you, so I may ask for that. My goal is to provide a complete answer to your question and to be sure you are satisfied with that answer.

I am sorry that you are having this problem but will do my best to assist you and answer your questions.    It seems that your son is very ill.    This is well past the point where his immune system will fight it off.

If this is dysentery, he needs to be in the hospital and on the recommended antibiotic. I’m not sure what the confusion is here at all.

Ciprofloxacin, ceftriaxone and pivmecillinam are the antibiotics currently recommended by the World Health Organization (WHO) for the treatment of dysentery in children.

Gentamicin is not effective.   Thank you for trusting Just Answer with your question. Please let me know if you have additional concerns or need me to clarify something. I am happy to help.

Customer: replied 16 days ago.
My wife asks if ciprofloxacin is safe for 14 month olds, which is the usual. First line. Ceftriaxone has a high risk on e coli and interacts with gentamicin, so she really does not support this decision.
Customer: replied 16 days ago.
She would like to know the doses for ciprofloxacin or azithromicyn injectable

Yes its safe.   Ceftriazone is safer and preferred.   I do not know what you mean be high risk E. coli.   And if the gentamicin is stopped already there is no concern.

Azithromycin is not effective.

Customer: replied 16 days ago.
These are the guidelines we are aware of

Cipro is dosed according to weight and dosing would be calculated by the hospital pharmacy

Customer: replied 16 days ago.
We do not know if it is shigella though, so should we stay on gentamicin which covers a wider scope. Of bacteria

Yes and ceftriaxone is on there.

In all fairness you are not going to be able to dictate the choice of antibiotics    I would suggest trusting the hospital staff.   Or getting an infectious disease consult     Thanks for using Just Answer.

Customer: replied 16 days ago.
I trust the WHO more and cipro is their first line recommendation
Customer: replied 16 days ago.
We do not know if it is shigella though, so should we stay on gentamicin which covers a wider scope of bacteria and he was responding well too. He has got worse under ceftriaxone and it can interfere with gentamicin

I answered that above.

Customer: replied 16 days ago.
Sorry, I missed some of your earlier comments. The issue is that we do not know it is dysentry, so this antibiotic is also a risk. He was improving well but due to an over reaction from my mother in law got taken to ER where under new treatment, lack of sleep and anxietu he deteriorated. Given we do not know what it is, will not know for a few days and he was improving on gentamicin, we are seeking advice on whether that is the safer route. The surgeon has also confirmed the blood in the stool is not a concern.

I do not agree that the antibiotic is a risk.   It sounds to me like your mother in law did not overreact.    If this were the case, he would not be still in the hospital.    The blood in the stoo is an indicator of an infectious disease process.   I would suggest accepting the treating physicians judgment and treatment plan.

Customer: replied 16 days ago.
To clarify, we are referring to gentsmacin by Injection which is shown to be effective on shigella, plus a wider range of bacteria and he was responding well. The physicians at the hospital are split and the dysentry route won by force of personality not by medical rationale let's say. Gentacamin worked and this didnt, so hard to know whether to trust a medical judgment without tests to back it up or just the evidence of improvement under gentamicin. I don't understand any of this but am passing on the updates.

I guess I would not agree with you that physicians would be split by a force of personality    You are reading too much into this.  Ask for an infectious disease specialist consult right away.

Dr. K. and other Medical Specialists are ready to help you
Customer: replied 16 days ago.
Physicians are human and that is human nature unfortunately. Thank you for your help. The new pediatrician on shift is more experienced, empathetic, thoughtful and trusted by the team, so we have more confidence now. Thanks again.