Occurrence of Clostridium difficile toxin-associated gastroenteritis following antibiotic therapy for otitis media in young children.
The pathogenesis of diarrhea following antibiotic therapy for otitis media in young children remains unknown. We performed a prospective study evaluating the incidence of diarrhea and Clostridium difficile toxin in 115 outpatients (ages 6 months to 6 years) with acute otitis media treated with ampicillin, amoxicillin or trimethoprim-sulfamethoxazole. In 21 patients younger than one year of age six of 11 developing diarrhea had toxin-positive stools compared with three of 10 without diarrhea (P = 0.39). In 94 patients between 13 months and 6 years of age three of 12 with diarrhea had toxin-positive stools compared with five of 82 without diarrhea (P = 0.06). Diarrhea was self-limited in all cases. Although the data suggest that C. difficile might have been associated with diarrhea in the older children, further studies will be required to confirm this finding.
D000658:Amoxicillin / Q000009:adverse effects* / Q000627:therapeutic use; D000667:Ampicillin / Q000009:adverse effects* / Q000627:therapeutic use; D001426:Bacterial Proteins; D001427:Bacterial Toxins / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D003013:Clostridium / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000139:chemically induced*; D004338:Drug Combinations / Q000009:adverse effects / Q000627:therapeutic use; D005243:Feces / Q000382:microbiology; D005759:Gastroenteritis / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D010033:Otitis Media / Q000188:drug therapy*; D011446:Prospective Studies; D013420:Sulfamethoxazole / Q000009:adverse effects* / Q000627:therapeutic use; D014295:Trimethoprim / Q000009:adverse effects* / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004338:Drug Combinations; C031815:toxB protein, Clostridium difficile; D000667:Ampicillin; D000658:Amoxicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole