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Antibiotic Associated Diarrhea
Aka: Antibiotic Associated Diarrhea, Diarrhea Secondary to Antibiotic Use, Antibiotic-Associated Diarrhea
- See Also
- Diarrhea Secondary to Medications
- 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]
- 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]
- Prevention: Probiotics
- Efficacy
- Number Needed to Treat (NNT): 13
- Treating 13 patients prevents one case of Antibiotic Associated Diarrhea
- 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)
- References
- (2012) Presc Lett 19(7): 39