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Related Experiment Videos

Antibiotic-induced colitis

A G Devenyi1

  • 1Department of Pediatrics, Milton S. Hershey Medical Center, Hershey, PA 17033, USA.

Seminars in Pediatric Surgery
|November 1, 1995
PubMed
Summary
This summary is machine-generated.

Antibiotic-associated diarrhea often involves Clostridium difficile (C. diff), ranging from mild symptoms to severe colitis. Treatment depends on severity, with oral metronidazole or vancomycin effective for uncomplicated cases, though relapses can occur.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Microbiology

Background:

  • Antibiotic-associated diarrhea (AAD) is a common clinical problem.
  • AAD can be categorized into Clostridium difficile-associated diarrhea (CDAD) and cases with unknown etiology.
  • C. difficile colonization presents a spectrum of illness, from asymptomatic carriage to potentially fatal pseudomembranous colitis.

Purpose of the Study:

  • To review the epidemiology, clinical features, and management of Clostridium difficile-associated diarrhea.
  • To highlight the role of various antibiotics in inducing C. difficile colitis.
  • To discuss treatment strategies and the challenge of recurrent disease.

Main Methods:

  • Literature review of studies on antibiotic-associated diarrhea and Clostridium difficile.

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  • Analysis of implicated antibiotic classes and their association with C. difficile colitis.
  • Evaluation of current treatment guidelines and therapeutic options.

    • Main Results:

    • Clindamycin is historically linked to C. difficile colitis, but broad-spectrum penicillins and cephalosporins are now most frequently implicated due to widespread use.
    • C. difficile is responsible for up to 25% of AAD cases without colitis and virtually all cases of pseudomembranous colitis.
    • Oral metronidazole and vancomycin show similar efficacy in uncomplicated CDAD; optimal treatment for severe cases remains undefined.

    Conclusions:

    • Management of AAD involves altering antimicrobial therapy, supportive care, and specific C. difficile eradication if necessary.
    • Relapse rates for C. difficile infections are significant (up to 15%) and difficult to predict or prevent.
    • Understanding the spectrum of C. difficile-related illness and implicated agents is crucial for effective patient management.