Dawaa Reference

acute

Diarrhoeal Disease

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

Egyptian National Drug Formulary - antimicrobial-2023.pdf, Metronidazole monograph (chapter PDF p307) · Nemeth V, Pfleghaar N. Diarrhea. [Updated 2022 Nov 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID NBK448082.

Verified against2 documents
  • Egyptian National Drug Formulary - antimicrobial-2023.pdf, Metronidazole monograph (chapter PDF p307)
  • Nemeth V, Pfleghaar N. Diarrhea. [Updated 2022 Nov 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID NBK448082.

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (4)

  • Rotavirus typically brings vomiting and dehydration, and costs more days off than other causes [dehydration · vomiting]
  • Volume, consistency, colour and frequency of the stool help narrow down the source
  • In a child with ongoing diarrhoea, wind, bloating and belly pain, ask how much juice is drunk [abdominal distension · abdominal pain · diarrhoea · flatulence]
  • How long it lasts and how it looks track the cause and the patient

Tests (12)

  • Uncomplicated acute diarrhoea needs no labs or imaging; culture the stool if there is blood or the patient is severely ill
  • Blood in the stool calls for Shiga toxin and lactoferrin as well
  • Recent antibiotics or a hospital stay means testing for Clostridium difficile
  • Test for C difficile with colitis or blood in stool - it can strike with no antibiotic exposure at all
  • Imaging is not routine, but marked peritoneal signs call for abdominal CT
  • For long-running diarrhoea: blood count, metabolic panel, TSH, ESR, liver panel and stool analysis
  • Sort long-running diarrhoea into watery, fatty or inflammatory before testing further
  • Stool pH under 5.5, or plenty of reducing substances, points to carbohydrate intolerance following a viral illness
  • White cells in stool mean large-bowel invasion and rule out enterotoxigenic E coli, Vibrio and viruses
  • With colitis or faecal white cells, culture for Shigella, Salmonella, Campylobacter, Yersinia and C difficile
  • After ground beef with enterohaemorrhagic E coli in stool, type it - O157:H7 can bring on haemolytic uraemic syndrome
  • Rotavirus and adenovirus antigens by immunoassay; for parasites send stool for ova and parasites every other day

If not this — what else fits (12)

  • Surgical mimics: appendicitis, intussusception, Meckel diverticulum
  • Giardiasis and carcinoid tumour also belong on the list
  • Malabsorption: glucose-galactose malabsorption, enterokinase deficiency, childhood malabsorption syndromes
  • Crohn disease and an overactive thyroid in a child
  • Nursery spread: rotavirus, astrovirus, calicivirus, Shigella, Giardia, Campylobacter, Cryptosporidium
  • Dairy points towards Campylobacter and Salmonella
  • Poultry points towards Campylobacter
  • Ground beef points towards enterohaemorrhagic E coli
  • Seafood points towards astrovirus, Aeromonas, Plesiomonas and Vibrio
  • Travellers diarrhoea is led by enterotoxigenic E coli
  • Chlorine does not kill Giardia, Cryptosporidium or Entamoeba, so suspect them with dirty water
  • Swimming pools carry Shigella; Aeromonas comes from the sea

Scores

  • WHO dehydration classification (child with diarrhoea) — How dehydrated is this child, and which rehydration plan?

Sourcedisease-level clinical article (toddlers-diarrhoea-full.txt)

Presentation findings are traced to the source above.

1

METRONIDAZOLE

1st line

Formoral.solid

Adult dose and duration

500 to 750 mg every 8 hours x 7 to 10 days

Paediatric dose

General susceptible-infection dosing: 15 to 50 mg/kg/day in divided doses 3 times daily, maximum 2,250 mg/day (this is the general oral dose given; it is not separately labelled for amoebiasis in the paediatric section).

Dose source

Egyptian National Drug Formulary - antimicrobial-2023.pdf, Metronidazole monograph (chapter PDF p307)

Why

Covers amoebic dysentery, one of the parasitic causes of diarrhoea a GP should consider treating when rehydration/symptomatic measures alone are not enough; this excerpt does not include a separate Giardia-specific dose.

Cautions
  • This dose is specifically for amoebic dysentery; this excerpt does not include a separate Giardia-specific dose, so if giardiasis rather than amoebiasis is suspected, confirm the correct dose from a source that covers it before prescribing.
  • Seek urgent care for dehydration, blood in the stool, high fever, symptoms lasting more than two weeks, or in an infant, elderly, or immunocompromised patient with poor oral intake.
  • Strictly avoid alcohol and propylene glycol-containing products during treatment and for 3 days (72 hours) after the last dose - Egyptian National Drug Formulary, Antimicrobial 2023.
Egyptian brands
Egyptian brandManufacturerIndicative price
TRICHOGYL 250 MG 20 TAB.EL NASR4.35 EGP (0.22/unit)
DUMOZOL 500MG 20 F.C. TABS.MINA PHARM > ALPHARMA-DENMARK7.00 EGP (0.35/unit)
FLAGICURE 250MG 20 TAB.KAHIRA7.00 EGP (0.35/unit)
METRONIDAZOLE-MUP 250 MG 20 F.C. TABS.MUP11.00 EGP (0.55/unit)
METROZOLE 250MG 20 TAB.MEMPHIS20.00 EGP (1.00/unit)
TRICHOGYL 500MG 12 F.C.TAB.EL NASR15.00 EGP (1.25/unit)
GEDAZOLE 500MG 20 TAB.JEDCO INT. CO. FOR PHARMACEUTICALS34.00 EGP (1.70/unit)
METROGYPTON 500 MG 20 F.C. TABS.GYPTO PHARMA34.00 EGP (1.70/unit)
DUMOZOL 125MG/5ML SUSP. 125ML? strength differs? different route - not oral solidMINA PHARM > ALPHARMA-DENMARK5.75 EGP
METROZOLE 125MG/5ML SUSP. 120 ML? strength differs? different route - not oral solidMEMPHIS19.50 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.