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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
PubMed

Insights

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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