Definition
Antibiotic-associated diarrhea is defined as otherwise unexplained diarrhea that occurs in association with antibiotic use. The antibiotic types most often related to antibiotic-associated diarrhea are cephalosporins, clindamycin, broad-spectrum penicillins, and ampicillin/amoxicillin. The clinical manifestations range from mild complaints of frequent loose and watery stools to severe, fulminant colitis (pseudomembranous colitis) with possible fatal outcome.
The mechanisms behind this antibiotic-associated diarrhea are multiple.
First, antibiotics may have direct effects on the gastrointestinal tract that contribute to the development of diarrhea. Erythromycin, for example, has a motilin receptor stimulating activity, and this prokinetic action results in faster gastric emptying and a shorter oro-cecal transit time.
Secondly, the antibiotic-induced alterations in the composition of resident microflora in the intestinal tract may influence normal gut functioning. Anaerobes...
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References and Further Reading
Beaugerie, L., & Petit, J. (2004). Antibiotic-associated diarrhea. Best Practice & Research Clinical Gastroenterology, 18, 337–352.
Cameselle-Teijeiro, J., Abdulkader, I., & Forteza, J. (2004). Signet-ring cell change in pseudomembranous colitis versus signet-ring cell carcinoma. The American Journal of Surgical Pathology, 28, 1111.
Högenauer, C., Langner, C., Beubler, E., Lippe, I. T., Schicho, R., Gorkiewicz, G., Krause, R., Gerstgrasser, N., Krejs, G. J., & Hinterleitner, T. A. (2006). Klebsiella oxytoca as a causative organism of antibiotic-associated hemorrhagic colitis. The New England Journal of Medicine, 355, 2418–2426.
Mylonakis, E., Ryan, E. T., & Calderwood, S. B. (2001). Clostridium difficile-associated diarrhea. A review. Archives of Internal Medicine, 161, 525–533.
Price, A. B., & Davies, D. R. (1977). Pseudomembranous colitis. Journal of Clinical Pathology, 30, 1–12.
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Ferdinande, L. (2017). Antibiotic-Associated Colitis. In: Carneiro, F., Chaves, P., Ensari, A. (eds) Pathology of the Gastrointestinal Tract. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-40560-5_1433
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DOI: https://doi.org/10.1007/978-3-319-40560-5_1433
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