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Moxifloxacin-induced Clostridium difficile-associated diarrhea
1Department of Clinical and Administrative Sciences, University of Oklahoma College of Pharmacy, Tulsa, Oklahoma 74135-2512, USA. doug-carroll@ouhsc.edu
Pharmacotherapy
|November 19, 2003
Summary
Moxifloxacin, an antibiotic, can cause Clostridium difficile-associated diarrhea (CDAD) by disrupting gut bacteria. This case highlights the importance of recognizing this potential side effect in patients receiving moxifloxacin.
Area of Science:
- Infectious Diseases
- Pharmacology
- Gastroenterology
Background:
- Antibiotic use is a primary risk factor for Clostridium difficile-associated diarrhea (CDAD).
- Disruption of normal colonic flora by antibiotics can lead to opportunistic infections like CDAD.
- Moxifloxacin, a broad-spectrum fluoroquinolone, is increasingly used for various infections.
Observation:
- A young woman presented with pneumonia, urinary tract infection, anemia, thrombocytopenia, and leukocytosis.
- She developed symptoms of CDAD, including diarrhea, cramping, and abdominal pain, after 5 days of moxifloxacin treatment.
- Clostridium difficile toxin was detected in her stool specimen, confirming the diagnosis.
Findings:
- The patient was diagnosed with Clostridium difficile-associated diarrhea (CDAD) while continuing moxifloxacin.
- Treatment with metronidazole led to the resolution of CDAD symptoms.
- This case demonstrates that moxifloxacin can induce CDAD, even with continued administration.
Implications:
- Clinicians must maintain a high index of suspicion for CDAD in patients treated with moxifloxacin.
- Awareness of moxifloxacin's potential to cause CDAD is crucial for appropriate patient management.
- Understanding antibiotic-induced CDAD is vital for optimizing patient outcomes and preventing complications.