Incidence and risk factors of oral antibiotic-associated diarrhea in an outpatient pediatric population.
BACKGROUND
Little information is available on the epidemiologic characteristics of antibiotic-associated diarrhea (AAD) in children. The authors' aim was to evaluate the incidence of AAD in an outpatient pediatric population and to identify risk factors.


METHODS
Children aged 1 month to 15.4 years treated with oral antibiotics for a proven or suspected infection were enrolled from an ambulatory pediatric practice during an 11-month period. Parents recorded the daily frequency and characteristics of stools using a diary during the antibiotic treatment and for 1 week after it was stopped. An episode of diarrhea was defined by at least 3 soft or liquid stools/d for at least 2 consecutive days. Risk factors for AAD-age, type of antibiotic treatment, type of combined treatment, and site of infection-were analyzed.


RESULTS
Of 650 children included, 11% had an episode of AAD, lasting a mean of 4.0 +/- 3.0 days, beginning a mean of 5.3 +/- 3.5 days after the start of antibiotic treatment. No child was hospitalized because of AAD. The incidence of AAD was higher in children less than 2 years (18%) than in those more than 2 years (3%; P < 0.0001). The incidence of AAD was particularly high after administration of certain antibiotics (amoxicillin/clavulanate, 23%; P = 0.003 compared with other antibiotics). The type of combined treatment and site of infection did not influence the onset of AAD.


CONCLUSIONS
Antibiotic-associated diarrhea was common in these outpatient children, especially for those aged less than 2 years and after the prescription of certain antibiotics, particularly, the combination of amoxicillin/clavulanate.
Turck
Dominique
D
Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Faculty of Medicine and Children's Hospital, Lille, France. dturck@chru-lille.fr
Bernet
Jean-Paul
JP
Marx
Jacques
J
Kempf
Hélène
H
Giard
Patrick
P
Walbaum
Olivier
O
Lacombe
André
A
Rembert
Françoise
F
Toursel
Francis
F
Bernasconi
Paul
P
Gottrand
Frédéric
F
McFarland
Lynne V
LV
Bloch
Karine
K
D000284:Administration, Oral; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000139:chemically induced* / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010045:Outpatients / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents