Antibiotic-associated diarrhea

Antibiotic-associated diarrhea (AAD) refers to the occurrence of diarrhea in relation to antibiotic treatments. Diarrhea is defined as the passage of loose or watery stools, typically three or more times in a 24-hour period.

Etiology

AAD can occur due to a variety of reasons. The most common cause is the disruption of the normal gut flora by the antibiotic therapy, leading to an overgrowth of pathogenic bacteria. The most notorious of these is Clostridium difficile, which can lead to severe diarrhea, colitis, and even death in severe cases. Other bacteria such as Staphylococcus aureus and Klebsiella oxytoca have also been implicated in AAD.

Clinical Features

The clinical features of AAD can range from mild diarrhea to severe colitis. Symptoms typically include watery diarrhea, abdominal pain, and fever. In severe cases, patients may present with dehydration, electrolyte imbalance, and signs of sepsis.

Diagnosis

Diagnosis of AAD is typically based on clinical features and a recent history of antibiotic use. Laboratory tests may include stool culture and testing for C. difficile toxins. In severe cases, endoscopy or computed tomography (CT) scan may be required.

Treatment

The first step in the treatment of AAD is usually the discontinuation of the offending antibiotic, if possible. In cases caused by C. difficile, specific antibiotic therapy such as metronidazole, vancomycin, or fidaxomicin may be required. Probiotics have also been used to restore the normal gut flora.

Prevention

Prevention strategies for AAD include the judicious use of antibiotics, use of probiotics, and infection control measures to prevent the spread of C. difficile.

See Also

• Clostridium difficile Colitis
• Probiotics
• Antibiotics