Antibiotic associated colitis

Abstract

It is a prospective study based on 100 consecutive cases of diarrhea following antibiotic therapy admitted to the pediatric services of J.N. Medical College, A.M.U., Aligarh between January to December 1987. They had C. penicillin (50), chloramphenicol (34), ampicillin (34), gentamicin (34), cephalosporin (4) and cotrimoxazole (4) for 3 days to 3 weeks prior to the onset of diarrhea. Apart from routine and special investigations, naked eye and microscopic examination of stool, its culture for pathogens includingCl. difficile were carried out in all cases. Presence ofCl. difficile cytotoxin was demonstrated by observing the cytopathic. Effect on veru cell culture, 18 grewCl. difficile (14 cyto toxin positive). Frequency of fever, vomiting, abdominal distension, dehydration and duration of diarrhea was not different (p>0.05) in the two groups. Purge rate and presence of mucus and blood inCl. difficile positive patients was significantly higher (p<0.05). EightCl. difficile positive (7 cytotoxin + ve) were subjected to endoscopy. Three of them showed P.M. colitis and 2 non specific colitis. Chloromycetin, gentamicin and penicillin were the main culprits responsible for AAC. None of the patients given ampicillin alone suffered from AAC. The mortality was 5%.