Management of Clostridium difficile infection and other antibiotic-associated diarrhoeas.
Most cases of antibiotic-associated diarrhoea are due to Clostridium difficile or are enigmatic. Patients with C. difficile-associated disease are more likely to have colitis, severe disease and nosocomial acquisition. The preferred diagnostic test is a C. difficile toxin assay using a tissue culture assay or enzyme immunoassay. The usual treatment is withdrawal of the inducing agent, sometimes supplemented with oral vancomycin or metronidazole. Response rates approach 100%; the major complication is relapse. Major complications include toxic megacolon, devastating diarrhoea, pseudomembranous colitis and hypoalbuminemia. Antibiotic-associated diarrhoea with negative tests for C. difficile toxin is usually dose-related and responds to antibiotic withdrawal.
Bartlett
J G
JG
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003967:Diarrhea / Q000139:chemically induced / Q000503:physiopathology / Q000628:therapy; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D011379:Prognosis
D000900:Anti-Bacterial Agents