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Antibiotic associated diarrhoea: infectious causes
A Ayyagari1, J Agarwal, A Garg
1Department of Microbiology, Sanjay Gandhi Post graduate Institute of Medical Sciences, Lucknow - 226014, UP, India.
Indian Journal of Medical Microbiology
|July 24, 2007
Summary
Clostridium difficile causes nearly 25% of antibiotic-associated diarrheas (AAD). Diagnosis and treatment vary from antibiotic withdrawal for mild cases to metronidazole or vancomycin for severe C. difficile infections.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Antibiotic-associated diarrhea (AAD) is a significant clinical issue.
- Clostridium difficile is the most common pathogen causing AAD, accounting for approximately 25% of cases.
- Other less frequent causes include Clostridium perfringens, Staphylococcus aureus, and Salmonella spp.
Purpose of the Study:
- To review the causes, clinical presentation, diagnosis, and management of antibiotic-associated diarrheas.
- To highlight the role of Clostridium difficile as a primary pathogen in AAD.
- To discuss treatment strategies for varying severities of AAD.
Main Methods:
- Literature review of antibiotic-associated diarrheas.
- Focus on Clostridium difficile infection (CDI) epidemiology and pathogenesis.
- Analysis of diagnostic methods and therapeutic interventions for AAD.
Main Results:
- Clostridium difficile is the leading identified cause of AAD.
- Antibiotics like clindamycin, cephalosporins, ampicillin, and amoxicillin are frequently associated with C. difficile-associated diarrhea.
- Diagnosis relies on toxin B cytotoxicity assays, with ELISA kits offering rapid but less sensitive results.
Conclusions:
- Mild to moderate AAD may resolve with antibiotic withdrawal.
- Severe cases of AAD require pharmacologic treatment, with oral metronidazole as first-line and oral vancomycin as second-line therapy.
- Probiotics show potential for managing recurrent cases of AAD.
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