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Pseudomembranous colitis after topical application of clindamycin
Archives of Dermatology
|March 1, 1981
Summary
Topical clindamycin hydrochloride for acne may cause Clostridium difficile-associated diarrhea and pseudomembranous colitis. Prompt treatment with oral vancomycin resolved symptoms in a young woman.
Area of Science:
- Dermatology
- Gastroenterology
- Infectious Diseases
Background:
- Acne vulgaris is a common skin condition often treated with topical antibiotics.
- Clindamycin hydrochloride is a frequently prescribed topical antibiotic for acne treatment.
Observation:
- A 24-year-old woman developed abdominal cramping and diarrhea shortly after initiating topical 1% clindamycin hydrochloride for facial acne.
- Clinical presentation suggested a gastrointestinal complication linked to the dermatological treatment.
Findings:
- Stool analysis revealed a significant titer of Clostridium difficile toxin.
- Sigmoidoscopy and colonic biopsy confirmed pseudomembranous colitis.
- The patient's symptoms were directly associated with topical clindamycin use.
Implications:
- Topical clindamycin, despite its localized application, can precipitate severe gastrointestinal conditions like C. difficile-associated diarrhea and pseudomembranous colitis.
- This case highlights the importance of considering antibiotic-induced colitis even with topical antibiotic use.
- Early recognition and appropriate management, including vancomycin therapy, are crucial for patient recovery.