- Discussion:
- pseudomembranous colitis & diarrhea are complications of antimicrobial therapy that have been recognized for many years;
- over past decade many cases of these disorders have been found to be attributable to toxin-producing strains of C. difficile;
- although
clindamycin continues to be linked to diarrhea & pseudo-membranous colitis, beta-lactam antibiotics have overtaken it as the predominant causative
factor, with 70 % of cases in one large series being associated w/ cephalosporins;
- syndrome occurs with nearly all antibiotics (except
vancomycin and parenteral
aminoglycosides), and small number of cases have
been linked to antineoplastic agents;
- Treatment:
- in severe cases or in those that do not respond to the cessation of inciting antibiotic, specific antimicrobial therapy against C. difficile has proved useful, originally
with oral
vancomycin, more recently w/
metronidazole, & in small number of cases w/
bacitracin;
Clostridium difficile infection in orthopaedic patients.
HJ Clarke, RH Jinnah, RP Byank et al.
JBJS Vol 72-A. 1990. p 1056-1059.
Epidemics of Diarrhea Caused by a Clindamycin-Resistant Strain of Clostridium difficile in Four Hospitals
Stuart Johnson et al. The New England Journal of Medicine -- November 25, 1999 -- Vol. 341, No. 22
