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Comparative study of diarrhea associated with clindamycin and ampicillin therapy

B D Brause, J A Romankiewicz, V Gotz

    The American Journal of Gastroenterology
    |March 1, 1980
    PubMed

    Insights

    Antibiotic-associated diarrhea from clindamycin and ampicillin occurred in 3.8% and 4.2% of patients, respectively. Combining both antibiotics significantly increased diarrhea incidence to 9.0%.

    Area of Science:

    • Infectious Diseases
    • Pharmacology
    • Gastroenterology

    Background:

    • Antibiotic-associated diarrhea (AAD) is a common adverse effect of antimicrobial therapy.
    • Clindamycin and ampicillin are frequently prescribed antibiotics with known gastrointestinal side effects.
    • Understanding the specific risks associated with these agents, individually and in combination, is crucial for patient safety.

    Purpose of the Study:

    • To prospectively investigate the incidence of diarrhea associated with clindamycin and ampicillin in adult inpatients.
    • To compare the risk of diarrhea when these antibiotics are used alone versus in combination.
    • To determine the duration of diarrhea in relation to antibiotic administration and completion.

    Main Methods:

    • Prospective study involving 606 adult inpatients over a 12-month period.
    • Patients received clindamycin (n=288), ampicillin (n=318), or a combination of both.
    • Incidence and duration of diarrhea were recorded and analyzed.

    Main Results:

    • The incidence of diarrhea was 3.8% for ampicillin and 4.2% for clindamycin (P > 0.05).
    • Patients receiving both clindamycin and ampicillin had a significantly higher incidence of diarrhea (9.0%, P < 0.05).
    • Diarrhea developing after antibiotic completion was 2-3 times longer in duration than that occurring during treatment.

    Conclusions:

    • While individual use of clindamycin or ampicillin showed similar low rates of diarrhea, their combined use significantly increases risk.
    • Post-antibiotic diarrhea can be prolonged, necessitating extended patient monitoring.
    • Close follow-up for 4-6 weeks after therapy completion is recommended to manage potential AAD.

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