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Colitis and diarrhoea: a problem with antibiotic therapy.

J P Beavis, R L Parsons, J Salfield

The British Journal of Surgery

|April 1, 1976

Summary

Antibiotic-associated diarrhea and colitis were studied in 1158 orthopedic patients. Lincomycin and clindamycin use was justified by low colitis incidence, but diarrhea necessitates immediate antibiotic discontinuation.

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Area of Science:

Infectious Diseases
Gastroenterology
Pharmacology

Background:

Antibiotics are frequently prescribed for orthopedic inpatients.
Certain antibiotics, including lincomycin and clindamycin, are common choices in this patient population.
Antibiotic-associated diarrhea and colitis are potential adverse effects.

Purpose of the Study:

To estimate the incidence of diarrhea and colitis in orthopedic inpatients.
To identify specific antibiotics associated with these gastrointestinal adverse events.
To evaluate the risk-benefit profile of commonly used antibiotics in this cohort.

Main Methods:

A 19-month observational study was conducted.
Data were collected from 1158 orthopedic inpatients.
Incidence rates of diarrhea and colitis were calculated based on antibiotic use.

Main Results:

The highest incidence of diarrhea was associated with lincomycin (22.2%), ampicillin/cloxacillin (17.2%), clindamycin (15.3%), and cloxacillin/tetracycline (12.5%).
Three cases of colitis were documented, two following lincomycin and one following clindamycin.
The overall incidence of colitis was low despite the use of lincomycin and clindamycin.

Conclusions:

The continued use of lincomycin and clindamycin in orthopedic inpatients is justified due to a low incidence of colitis.
Patients developing diarrhea while on lincomycin or clindamycin should have the antibiotic discontinued promptly to mitigate colitis risk.
Early recognition and management of antibiotic-associated diarrhea are crucial in preventing severe complications like colitis.

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