Pharm
Antibiotic Associated Diarrhea
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Antibiotic Associated Diarrhea
, Diarrhea Secondary to Antibiotic Use, Antibiotic-Associated Diarrhea
See Also
Diarrhea Secondary to Medications
Precautions
Antibiotics in the emergency department frequently cause
Diarrhea
IV antibiotics: 26% of cases
Oral antibiotics: 12% of cases
Vancomycin
,
Clindamycin
and antibiotic combinations were highest risk for
Diarrhea
Reconsider whether antibiotics are indicated and if so, if IV route is needed
Oral
Bioavailability
of most antibiotics is excellent
Single dose IV antibiotics prior to home oral antibiotics is rarely indicated
References
Arora and Menchine in Herbert (2015) EM:Rap 15(1): 11
Haran (2014) Am J Emerg Med 32(10):1195-9 +PMID:25149599 [PubMed]
Causes
Bacteria
l Overgrowth Syndromes secondary to antibiotics
Clostridium difficile
Klebsiella
oxytoca
Responds to stopping antibiotics (and possibly to stopping
NSAID
s)
Högenauer (2006) N Engl J Med 355:2418-26 [PubMed]
Prevention
Probiotic
s
Efficacy
Number Needed to Treat
(NNT): 13 to 20
Treating 13 to 20 patients prevents one case of Antibiotic Associated Diarrhea
Live-culture yogurt reduces
Diarrhea
due to antibiotics
Lactobacillus acidophilus
Lactobacillus bulgaricus
Streptococcus
thermophilus
Beniwal (2003) Dig Dis Sci 48:2077-82 [PubMed]
Other specific formulations
Lactobacillus (Culturelle, DanActive)
Saccharomyces boulardii (Florastor)
References
(2012) Presc Lett 19(7): 39
Goodman (2021) BMJ Open 11(8): e043054 [PubMed]
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