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Abstract:
Among 26,294 hospitalized patients monitored by the Boston Collaborative Drug Surveillance Program (BCDSP), 8,948 (34%) received at least one antibiotic, and none were diagnosed as having drug-induced colitis to in-hospital antibiotic exposure. Seven patients who had taken antibiotics as outpatients, however, were admitted with antibiotic-associated colitis. Six of these patients had taken lincomycin prior to the onset of symptoms; one had taken ampicillin. Six of the patients were hospitalized at a New Zealand hospital and one at a hospital in Canada. The five patients with lincomycin-associated colitis at the New Zealand hospital were admitted over an 11-month period. Severe colitis due to antibiotics has been a rare event in the BCDSP experience, especially in the United States.
Insights
Antibiotic-associated colitis is rare in hospitalized patients, but can occur in outpatients. This study found seven outpatient cases, primarily linked to lincomycin, highlighting a rare but serious adverse drug event.
Area of Science:
- Pharmacovigilance
- Gastroenterology
- Infectious Diseases
Background:
- Antibiotics are widely used, but can cause adverse drug reactions.
- Drug-induced colitis is a known, though infrequent, complication of antibiotic therapy.
- Hospitalized patients in the Boston Collaborative Drug Surveillance Program (BCDSP) showed no cases of in-hospital antibiotic-induced colitis.
Purpose of the Study:
- To investigate the incidence and characteristics of antibiotic-associated colitis.
- To identify specific antibiotics linked to colitis in outpatient settings.
Main Methods:
- Retrospective review of hospitalized patients within the BCDSP.
- Analysis of cases presenting with antibiotic-associated colitis, focusing on prior antibiotic exposure.
- Case series of seven outpatients diagnosed with antibiotic-associated colitis.
Main Results:
- No cases of antibiotic-induced colitis were diagnosed among 26,294 hospitalized patients receiving antibiotics.
- Seven outpatients were admitted with antibiotic-associated colitis.
- Six of these seven patients had taken lincomycin; one had taken ampicillin.
- Five lincomycin cases occurred within an 11-month period at a New Zealand hospital.
Conclusions:
- Antibiotic-associated colitis is a rare event, particularly in hospitalized patients in the US.
- Outpatient antibiotic use, especially lincomycin, may be associated with a risk of developing colitis.
- Further surveillance may be needed to fully understand the risk of antibiotic-associated colitis in outpatient settings.