The role of antimicrobial agents in the aetiology of Clostridium difficile-associated disease.
High Clostridium difficile disease rates were originally associated with clindamycin use, but this association has declined in recent years following the decline in the clinical use of clindamycin, and disease is now particularly associated with the use of broad-spectrum antibiotics, especially the cephalosporins. There are now sufficient reports in the literature to merit the discontinuation of the widespread use of cephalosporins, especially in the elderly, by the substitution, wherever possible, with antibiotics not associated with the promotion of C. difficile-associated disease. Such agents include benzylpenicillin, gentamicin, trimethoprim, ciprofloxacin and the ureido-penicillins. Widespread education about the proper use of antibiotics in clinical practice remains essential.
Spencer
R C
RC
Bristol Public Health Laboratory, Bristol Royal Infirmary, UK.
D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002511:Cephalosporins / Q000009:adverse effects; D016360:Clostridioides difficile; D004761:Enterocolitis, Pseudomembranous / Q000139:chemically induced / Q000209:etiology* / Q000382:microbiology; D006801:Humans
D000900:Anti-Bacterial Agents; D002511:Cephalosporins