Oamar Sultana, Naseer Ahmed Chaudrhy, Muhammad Saeed Anwar, Muhammad Munir, Muhammad Tayyab.
Association of Antibiotics with Diarrhoea and Clostridium Difficile Infection.
Biomedica Jan ;16:54-9.

Antibiotic associated Diarrhoea (AAD) and clostridium difficile (C. difficile) associated Diarrhoea (CDAD) are the side effects of the use of antibiotics. A study was conducted to assess the role of antimicrobial agents as a cause of C. difficile associated Diarrhoea. The study included 80 adult patients with AAD. Stool specimens of all these subjects were inoculated on cycloserine cefoxitin fructose agar and incubated anaerobically to isolate C. difficile. At the same time all the stool specimens were tested for C. difficile toxin by ELISA technique using cytoclone A and B kit manufactured by Cambridge Biotech corporation, Worcester, Massachusetts. Out of 80 patients with AAD, Significantly higher numbers of patients (P<0.001) were taking multiple antibiotics as compared to patients taking single antibiotic. Similarly statistical difference was significant (P<0.001) amongst patients taking antibiotics for longer duration as compared to patients taking antibiotic for one week duration. Much higher percentage (41.1%) of patients receiving macrolides (clindamycin / Lincomycin) and or cephalosporins showed evidence of C. difficile infection as compared to patients receiving macrolides / cephalosporins with other antibiotics (25.9%) or taking antibiotic other than macrolides / cephalosporins (31.5%). Almost all antibiotics can cause AAD and CDAAD. The commonest antibiotics responsible for AAD and CDAAD were macrolides and cephalosporins. More over C. difficile can be held responsible for diarrhoea in approximately one third of these AAD patients.

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