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Lincomycin-clindamycin-associated psuedomembranous colitis
Abstract:
Five cases of lincomycin-clindamycin-associated acute pseudomembranous colitis, demonstrating a spectrum of clinical, histological and radiological severity, were encountered over a five-months period. All patients presented with watery diarrhoea without the passage of macroscopic blood or pus. Two patients were seriously ill with fulminant colitis, but responded rapidly to corticosteroids given parenterally and supportive therapy. The diagnosis of acute colitis should be considered in all patients developing diarrhoea during or up to three weeks after beginning therapy with lincomycin or clindamycin and can be confirmed by sigmoidoscopic examination. Withdrawal of the antibiotic and symptomatic treatment is appropriate for mild cases of colitis, but our experience suggests that corticosteroid therapy is safe and effective in severe cases. Indiscriminate use of these antibiotics should be avoided.
Insights
Lincomycin and clindamycin can cause acute pseudomembranous colitis. Severe cases may benefit from corticosteroid therapy, alongside supportive care.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pharmacology
Background:
- Lincomycin and clindamycin are antibiotics sometimes associated with severe gastrointestinal side effects.
- Acute pseudomembranous colitis is a serious condition that can arise during or after antibiotic treatment.
Observation:
- A five-month period revealed five cases of lincomycin-clindamycin-associated acute pseudomembranous colitis.
- Patients presented with watery diarrhea; two had severe, fulminant colitis.
- Diagnosis can be confirmed via sigmoidoscopy.
Findings:
- Mild colitis cases responded to antibiotic withdrawal and symptomatic treatment.
- Severe colitis cases showed rapid improvement with parenteral corticosteroids and supportive therapy.
- The clinical, histological, and radiological severity varied among the cases.
Implications:
- Healthcare providers should consider colitis in patients with diarrhea during or after lincomycin/clindamycin therapy.
- Antibiotic stewardship is crucial to avoid indiscriminate use of these drugs.
- Corticosteroids appear safe and effective for severe antibiotic-associated colitis.