{
  "schema_version": 1,
  "kind": "condition",
  "id": "food-poisoning-bacterial",
  "name": "Bacterial Food Poisoning (Toxin Gastroenteritis)",
  "category": "infectious",
  "sources": "Egyptian National Drug Formulary - Gastrointestinal 2025, hyoscine-N-butyl bromide monograph (printed page 46, endf-git.txt), which gives adult oral dosing as \"Initial: 10 mg three times daily\" and \"Dose can be increased up to 20 mg four times daily if necessary\", and states \"Pediatric dosing (6-12 years) Oral: 10 mg three times daily.\" · CDC Foodborne Illness Guidelines · Egyptian National Drug Formulary, GI 2024, hyoscine-N-butyl bromide monograph (printed pp. 45-46) · WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 · WHO/UNICEF reduced-osmolarity oral rehydration salts (245 mOsm/L), recommended since 2002",
  "review_status": "reviewed",
  "verified_against": "Egyptian National Drug Formulary - Gastrointestinal 2025, hyoscine-N-butyl bromide monograph (printed page 46, endf-git.txt), which gives adult oral dosing as \"Initial: 10 mg three times daily\" and \"Dose can be increased up to 20 mg four times daily if necessary\", and states \"Pediatric dosing (6-12 years) Oral: 10 mg three times daily.\" · Egyptian National Drug Formulary, GI 2024, hyoscine-N-butyl bromide monograph (printed pp. 45-46) · WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 775,
      "generic": "ORS",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.liquid",
      "strength_mg": null,
      "adult_dose": "Drink 200-400 mL after each loose stool, or as much as desired to maintain hydration.",
      "adult_duration": "24-48 hours until symptoms resolve",
      "dose_source": "WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005",
      "rationale": "Oral rehydration solution replaces the fluid and electrolyte losses from bacterial toxin-mediated gastroenteritis; fluid replacement is the mainstay of treatment, since the illness is usually self-limiting and antibiotics are not recommended for this type of food poisoning.",
      "cautions": [
        "Never make the solution up in less water than the pack states. A five-fold concentrated ORS given to a dehydrated patient causes hypernatraemia, and an infant is the one least able to survive it.",
        "Mainstay of treatment is fluid replacement; preformed toxin illness resolves spontaneously in 1-2 days.",
        "Empirical antibiotics are NOT recommended for simple emetic/diarrhoeal toxin food poisoning.",
        "Seek emergency care if bloody diarrhoea, high fever, or signs of severe dehydration present.",
        "Use the reduced-osmolarity formulation (sodium 75, glucose 75, potassium 20, citrate 10, chloride 65 mmol/L; 245 mOsm/L). WHO replaced the older 311 mOsm/L formula in 2002 for diarrhoea of any cause at any age - it cuts stool output and vomiting."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Give 50-100 mL after each watery stool in young children",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "GLUCOHYDRAN 10 SACHET.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ARAB DRUG COMPANY (ADCO)",
          "price_egp": 1.75,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "REHYDRAN N 10 SACHET",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "CID",
          "price_egp": 4.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "REHYDRO ZINC 10 SACHETS",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "CID",
          "price_egp": 7.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ORS 20 SACHETS",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHAROPHARMA",
          "price_egp": 40.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ELECTRO MASH SYRUP 200 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MASH PREMIERE",
          "price_egp": 60.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FLEXOLYTE ORAL REHYDRATION SOL. 240 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "KEMPETRO FOR CHEMICAL INDUSTRIES",
          "price_egp": 65.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "HERO ORS 200 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "HERO > HERO MEA TRADING",
          "price_egp": 120.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "SANSO ORS SYRUP 140 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "AUG PHARMA",
          "price_egp": 400.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "food-poisoning-bacterial"
    },
    {
      "id": 776,
      "generic": "Hyoscin-N-butylbromid",
      "line": 1,
      "is_adjunct": true,
      "form": "oral.solid",
      "strength_mg": 10.0,
      "adult_dose": "10-20 mg 3-4 times daily as needed for painful abdominal cramps",
      "adult_duration": "1-2 days as needed",
      "dose_source": "Egyptian National Drug Formulary - Gastrointestinal 2025, hyoscine-N-butyl bromide monograph (printed page 46, endf-git.txt), which gives adult oral dosing as \"Initial: 10 mg three times daily\" and \"Dose can be increased up to 20 mg four times daily if necessary\", and states \"Pediatric dosing (6-12 years) Oral: 10 mg three times daily.\"",
      "rationale": "Antispasmodic for acute cramping abdominal pain",
      "cautions": [
        "Avoid in paralytic ileus, narrow-angle glaucoma, or severe ulcerative colitis.",
        "Anticholinergic side effects include dry mouth, blurred vision, and tachycardia.",
        "Also barred by: myasthenia gravis, megacolon, and any mechanical narrowing or obstruction of the gut.",
        "Not a drug to take every day indefinitely. If the cramps keep coming back, the job is to find out why, not to keep prescribing the antispasmodic.",
        "The injection is licensed for adults only, 20 mg repeated after half an hour if needed, never past 100 mg in a day. Children get the oral form."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children 6-12 years: 10 mg 3 times daily as needed. Not recommended under 6 years",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": [
        {
          "label": "6 to 12 years",
          "age_min_months": 72,
          "age_max_months": 155,
          "dose_text": "10 mg three times daily as needed. Not recommended under 6 years."
        }
      ],
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "NU-SPASM 10 MG 20 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EIPICO",
          "price_egp": 4.0,
          "pack_count": 20,
          "unit_price": 0.2,
          "strength_mg": 10.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "BUTACID 10MG 20 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "CID",
          "price_egp": 20.0,
          "pack_count": 20,
          "unit_price": 1.0,
          "strength_mg": 10.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "SPASMOCIN 10MG 20 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MEMPHIS",
          "price_egp": 34.0,
          "pack_count": 20,
          "unit_price": 1.7,
          "strength_mg": 10.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "BUSCOPAN 10 MG 20 SUGAR C.TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SERVIER > Opella Healthcare",
          "price_egp": 56.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 10.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "SPASMOCIN 100MG/100ML SYRUP 120ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MEMPHIS",
          "price_egp": 3.85,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 100.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FARCORELAXIN 1MG/ML SYRUP 120ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHARCO",
          "price_egp": 4.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "food-poisoning-bacterial"
    }
  ]
}