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Chemotherapy 2005;51 (Suppl. 1):81-89 (DOI: 10.1159/000081993)

  Key Words

• Antibiotic-associated diarrhea
• Pseudomembranous colitis
• Clostridium difficile
• Rifaximin
• Clostridium difficile-associated diarrhea

  Abstract

Diarrhea is a well-known complication of antibiotic therapy. Rates of antibiotic-associated diarrhea (AAD) vary from 5 to 25%. Some antibiotics are more likely to cause diarrhea than others, specifically, those that are broad spectrum and those that target anaerobic flora. This paper reviews the effects of antibiotics on the fecal flora as well as host factors which contribute to AAD. Clinical features and treatment of AAD are also described. Prevention of AAD rests on wise antibiotic policies, the use of probiotics and prevention of acquisition in the hospital setting. Data from clinical trials suggest that poorly absorbed antimicrobials might have a decreased risk of causing AAD and Clostridium difficile-associated disease, as concluded from studies of antibiotics used for preoperative bowel decontamination and poorly absorbed antibiotics used for traveler's diarrhea. Controlled trials would prove this but are not yet available. Probiotics may be a good adjunct to poorly absorbed antibiotics to minimize the risk of diarrhea associated with antibiotics.

Copyright © 2005 S. Karger AG, Basel

  Author Contacts

Christina M. Surawicz, MD, FACP, FACG
Harborview Medical Center
325 Ninth Avenue, Box 359773
Seattle, WA 98104 (USA)
Tel. +1 206 341 4634, Fax +1 206 731 8698, E-Mail surawicz@u.washington.edu

  Article Information

Number of Print Pages : 9
Number of Figures : 1, Number of Tables : 3, Number of References : 78