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Antibiotic associated colitis

S H Ahmad1, P Kumar, S Fakhir

  • 1Department of Pediatrics, J.N. Medical College, Aligarh Muslim University.

Indian Journal of Pediatrics
|July 1, 1993
PubMed
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Antibiotic-associated diarrhea (AAD) in children is often linked to Clostridioides difficile. Certain antibiotics like chloramphenicol, gentamicin, and penicillin are frequently implicated, highlighting the need for careful antibiotic selection in pediatric care.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Gastroenterology

Background:

  • Antibiotic-associated diarrhea (AAD) is a common complication following antibiotic use in children.
  • Clostridioides difficile (C. diff) is a significant pathogen implicated in AAD, particularly in healthcare settings.

Purpose of the Study:

  • To investigate the incidence and clinical features of AAD in pediatric patients.
  • To identify the specific antibiotics associated with AAD and the role of C. diff.

Main Methods:

  • Prospective study of 100 pediatric patients with diarrhea post-antibiotic therapy.
  • Stool analysis including microscopy, culture for pathogens (including C. diff), and C. diff cytotoxin assay.
  • Endoscopic examination in selected C. diff positive cases.

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Main Results:

  • Clostridioides difficile was detected in 18% of cases, with 14% being cytotoxin-positive.
  • Patients with C. diff showed significantly higher purge rates and presence of mucus/blood in stool.
  • Antibiotics like chloramphenicol, gentamicin, and penicillin were strongly associated with AAD; ampicillin alone was not.
  • Endoscopy revealed pseudomembranous colitis in 3 cases and non-specific colitis in 2 cases.

Conclusions:

  • Clostridioides difficile is a key contributor to severe AAD in pediatric patients.
  • Specific antibiotics are more frequently associated with AAD, necessitating cautious prescription.
  • Early identification and management of C. diff are crucial for improving patient outcomes and reducing mortality.