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Cefotaxime-associated diarrhea and Clostridium difficile
The Japanese Journal of Antibiotics
|April 1, 1984
Summary
A patient with rheumatoid arthritis and interstitial pneumonitis developed Clostridium difficile colitis while on cefotaxime. Treatment involved stopping cefotaxime and using oral vancomycin for successful recovery.
Area of Science:
- Rheumatology
- Infectious Diseases
- Gastroenterology
Background:
- Rheumatoid arthritis patients often receive immunosuppressive therapies.
- Interstitial pneumonitis is a known complication of rheumatoid arthritis.
- Broad-spectrum antibiotics can disrupt gut microbiota, increasing C. difficile risk.
Observation:
- A patient with rheumatoid arthritis-associated interstitial pneumonitis was treated with prednisolone.
- The patient developed mild colitis attributed to Clostridium difficile.
- Cefotaxime (CTX) was identified as a potential contributing factor.
Findings:
- Discontinuation of cefotaxime (CTX) led to symptom improvement.
- Initiation of oral vancomycin provided successful treatment for the Clostridium difficile colitis.
- This case highlights antibiotic-induced C. difficile in an immunocompromised patient.
Implications:
- Clinicians should consider C. difficile infection in rheumatoid arthritis patients with diarrhea, especially those on antibiotics.
- Judicious antibiotic use is crucial in immunocompromised patients.
- Oral vancomycin is an effective treatment for C. difficile colitis in this context.