Managing antibiotic associated diarrhoea

doi:10.1136/bmj.324.7350.1345

BMJ 2002;324:1345-1346 ( 8 June )

Editorials

Managing antibiotic associated diarrhoea

Probiotics may help in prevention

Papers p 1361

The first 150 words of the full text of this article appear below.

Diarrhoea is a common adverse effect of antibiotic treatments. Antibiotic associated diarrhoea occurs in about 5-30% of patientseither early during antibiotic therapy or up to two months afterthe end of the treatment.^1-3 The frequency of antibiotic associateddiarrhoea depends on the definition of diarrhoea, the incitingantimicrobial agents, and hostfactors.

Almost all antibiotics, particularly those that act on anaerobes, can cause diarrhoea, but the risk is higher with aminopenicillins,a combination of aminopenicillins and clavulanate, cephalosporins,and clindamycin. ¹ ⁴ ⁵ Host factors for antibiotic associateddiarrhoea include age over 65, immunosuppression, being in anintensive care unit, and prolonged hospitalisation.⁶

Clinical presentations of antibiotic associated diarrhoea range from mild diarrhoea to fulminant pseudomembranous colitis.The latter is characterised by a watery diarrhoea, fever (in 80%of cases), leucocytosis (80%), and the presence of pseudomembraneson endoscopic examination. Severe complications include toxicmegacolon, perforation, andshock.

Antibiotic associated diarrhoea results from . . . [Full text of this article]

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