Skip to main content
Log in

Acute right-sided hemorrhagic colitis associated with oral administration of ampicillin

  • Orignial Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Among 56 cases who presented to Kanto-Teishin Hospital complaining of bloody diarrhea or considerable hematochezia of acute onset, 8 cases (14.3%) were considered due to colitis associated with oral ampicillin therapy. The bloody diarrhea, often with abdominal cramps, began 2–7 days after starting the treatment. The dosage of ampicillin taken ranged from 2.0 to 4.5 g. Early total colonoscopy and biopsy revealed marked mucosal hemorrhage with minimal or no inflammatory changes mainly in the right colon. Rectum and sigmoid colon are completely normal except in one case. Symptoms rapidly resolved after the endoscopy. At follow-up colonoscopy, performed 4–12 days later, the mucosal changes had cleared completely. There was no evidence to support a hypersensitivity reaction of the colonic mucosa to ampicillin. We believe that right-sided hemorrhagic colitis is one of the common forms of colitis associated with ampicillin. Its differentiation from other kinds of acute colitis and the importance of early total colonoscopy are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Tedesco FJ, Barton RW, Alpers PH: Clindamycin-associated colitis—a prospective study. Ann Intern Med 81:429–433, 1974

    Google Scholar 

  2. Keating JP, Frank AL, Barton LL, Tedesco FJ: Pseudomembranous colitis associated with ampicillin therapy. Am J Dis Child 128:369–370, 1974

    Google Scholar 

  3. Swartzberg JE, Maresca RM, Remington JS: Clinical study of gastrointestinal complications associated with clindamycin therapy. J Infect Dis 135 (suppl):99–103, 1977

    Google Scholar 

  4. Lusk RH, Fekety FR, Jr, Silva J, Jr, Bodendorfer T, et al: Gastrointestinal side effect of clindamycin and ampicillin therapy. J Infect Dis 135(suppl):111–119, 1977

    Google Scholar 

  5. Gurwith MJ, Rabin HR, Love K: Diarrhea associated with clindamycin and ampicillin therapy-preliminary results of a cooperative study. J Infect Dis 135(suppl):104–110, 1977

    Google Scholar 

  6. Bartlett JG, Moon N, Chang TW, Taylor N, Onderdonk AB: Role of clostridium difficile in antibiotic-associated pseudomembranous colitis. Gastroenterology 75:778–782, 1978

    Google Scholar 

  7. Hutcheon DR, Milligan FD, Yardley JH, Hendrix TR: Cephalosporin-associated pseudomembranous colitis. Am J Dig Dis 23:321–326, 1978

    Google Scholar 

  8. Kappas A, Shinagawa N, et al: Diagnosis of pseudomembranous colitis. Br Med J 1:675–678, 1978

    Google Scholar 

  9. Pittman FE, Pittman JC, Humphrey CK: Colitis following oral lincomycin therapy. Arch Intern Med 134:368–372, 1974

    Google Scholar 

  10. Manashil GB, Kern JA: Nonspecific colitis following oral lincomycin therapy. Am J Gastroenerol 60:394–399, 1973

    Google Scholar 

  11. Totani T: Acute hemorrhagic enteritis byKlebsilla oxytoca (in Japanese). Nihon-Rinsho 36:1308–1309, 1978

    Google Scholar 

  12. Finegold SM, Attebery HR, Sutter VL: Effect of diet on human fecal flora. Comparison of Japanese and American diet. Am J Clin Nutr 27:1456–1469, 1974

    Google Scholar 

  13. Toffler RB, Pingoud EG, Barrell MI: Acute colitis related to penicillin and penicillin derivatives. Lancet 2:707–709, 1978

    Google Scholar 

  14. Dahl MGC, Marks JM: Penicillin-associated colitis. Lancet 2:843, 1978

    Google Scholar 

  15. Bartlett JG, Chang TW, Gurwith M, Gorbach SL, Onderdonk AB: Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. N Engl J Med 298:531–534, 1974

    Google Scholar 

  16. Kreutzer EW, Milligan FD: Treatment of antibiotic-associated pseudomembranous colitis with cholestyramine resine. Johns Hopkins Med J 143:67–72, 1968

    Google Scholar 

  17. Katz L, Lamont T, Trier JS, et al: Experimental clindamycin-associated colitis in rabbits. Evidence for toxin-mediated mucosal damage. Gastroenterology 74:246–252, 1978

    Google Scholar 

  18. Allo M, Silva J, Jr, Fekety R, Rifkin GD, Waskin H: Prevention of clindamycin-induced colitis in hamster byClostridium sordellii antitoxin. Gastroenterology 76:351–355, 1979

    Google Scholar 

  19. Humphrey CD, Condon CW, Cantey JR, Pittmann FE: Partial purification of a toxin found in hamsters with antibiotic associated colitis. Gastroenterology 76:468–476, 1979

    Google Scholar 

  20. Cowan ST: Manual for Identification of Medical Bacteria, 2nd ed. London, Cambridge Press, 1974

    Google Scholar 

  21. Bartlett JG, Onderdonk AB, Cisneros RL: Clindamycin-associated colitis in hamster, protection with vancomycin. Gastroenterology 73:772–776, 1977

    Google Scholar 

  22. Farrar WE, Kent TH: Enteritis and coliform bacteremia in guinea pigs given penicillin. Am J Pathol 47:629–642, 1965

    Google Scholar 

  23. Lee A, Gordon J, Dubos R: Enumeration of the oxygen sensitive bacteria usually present in the intestine of healthy mice. Nature 220:1137–1139, 1968

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sakurai, Y., Tsuchiya, H., Ikegami, F. et al. Acute right-sided hemorrhagic colitis associated with oral administration of ampicillin. Digest Dis Sci 24, 910–915 (1979). https://doi.org/10.1007/BF01311944

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01311944

Keywords

Navigation