Role of candida in pathogenesis of antibiotic-associated diarrhoea in elderly inpatients.
The part that candida plays in antibiotic-associated diarrhoea was investigated in 24 elderly inpatients (mean age 74 years) who tested negative for Clostridium difficile toxin and other intestinal pathogens. 7 had intestinal overgrowth of Candida species (greater than or equal to 10(5) cfu/ml). None of the 24 matched, antibiotic-treated controls without diarrhoea had candida overgrowth. All 5 patients with diarrhoea and candida overgrowth treated with oral nystatin responded with resolution of diarrhoea and lowering of faecal counts to less than 10(4) cfu/ml within 7 days of start of antifungal therapy despite continuation of antibacterial therapy. In the other 2 patients with candida overgrowth, the diarrhoea subsided spontaneously and faecal candida counts returned to normal (less than 10(4) cfu/ml) after antibacterial agents were withdrawn. In patients without candida overgrowth, diarrhoea persisted until antibiotics were withdrawn, at a mean of 16 days after study entry.
Danna
P L
PL
Infectious Disease Section, Booth Memorial Medical Centre, Flushing, New York 11355.
Urban
C
C
Bellin
E
E
Rahal
J J
JJ
D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002175:Candida / Q000187:drug effects* / Q000302:isolation & purification; D003428:Cross Infection / Q000139:chemically induced / Q000188:drug therapy / Q000382:microbiology*; D003967:Diarrhea / Q000139:chemically induced / Q000188:drug therapy / Q000382:microbiology*; D005069:Evaluation Studies as Topic; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D009761:Nystatin / Q000627:therapeutic use*; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D009761:Nystatin