II. Precautions
-
Antibiotics in the emergency department frequently cause Diarrhea
- IV Antibiotics: 26% of cases
- Oral Antibiotics: 12% of cases
- Vancomycin, Clindamycin and Antibiotic combinations were highest risk for Diarrhea
- Reconsider whether Antibiotics are indicated and if so, if IV route is needed
- Oral Bioavailability of most Antibiotics is excellent
- Single dose IV Antibiotics prior to home oral Antibiotics is rarely indicated
- References
- Arora and Menchine in Herbert (2015) EM:Rap 15(1): 11
- Haran (2014) Am J Emerg Med 32(10):1195-9 +PMID:25149599 [PubMed]
III. Causes: Bacterial Overgrowth Syndromes secondary to Antibiotics
- Clostridium difficile
-
Klebsiella oxytoca
- Responds to stopping Antibiotics (and possibly to stopping NSAIDs)
- Högenauer (2006) N Engl J Med 355:2418-26 [PubMed]
IV. Prevention: Probiotics
- Efficacy
- Number Needed to Treat (NNT): 13 to 20
- Treating 13 to 20 patients prevents one case of Antibiotic Associated Diarrhea
- Number Needed to Treat (NNT): 13 to 20
- Live-culture yogurt reduces Diarrhea due to Antibiotics
- Lactobacillus acidophilus
- Lactobacillus bulgaricus
- Streptococcus thermophilus
- Beniwal (2003) Dig Dis Sci 48:2077-82 [PubMed]
- Other specific formulations
- Lactobacillus (Culturelle, DanActive)
- Saccharomyces boulardii (Florastor)
V. References
- (2012) Presc Lett 19(7): 39
- Goodman (2021) BMJ Open 11(8): e043054 [PubMed]
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Related Studies
Concepts | Disease or Syndrome (T047) |
SnomedCT | 301469002 |
Dutch | antibiotica-geassocieerde diarree, antibioticumgeassocieerde diarree |
French | Diarrhée associée aux antibiotiques, Diarrhée liée aux antibiotiques |
German | durch Antiobiotika verursachte Diarrhoe |
Italian | Diarrea da antibiotici |
Portuguese | Diarreia associada a antibióticos |
Spanish | Diarrea asociada a los antibióticos, Diarrea asociada a antibióticos, diarrea asociada con antibióticos (trastorno), diarrea asociada con antibióticos |
Japanese | 抗生物質関連下痢, コウセイブッシツカンレンゲリ |
English | Antibiotic assoc diarrhea, Antibiotic assoc diarrhoea, Antibiotic associated diarrhea, Antibiotic associated diarrhoea, antibiotics associated diarrhea, antibiotic-associated diarrhea, antibiotic associated diarrhea, Antibiotic-associated diarrhea, Antibiotic-associated diarrhoea, Antibiotic-associated diarrhea (disorder), Antibiotic associated diarrhea (disorder) |
Czech | Průjem spojený s léčbou antibiotiky |
Hungarian | Antibiotikum-asszociált hasmenés |