Antibiotic associated diarrhoea

ABSTRACT

In this work, 100 stool specimens were studied for the incidence of Clostridium difficile [C. Difficile] among 2 groups of subjects; 50 patients, who had diarrhea after a course of antibiotics, and 50 healthy cases. We showed that C. Difficile was isolated and identified in 18% [9 of 50] of post-antibiotic diarrheal patients, and in 2% [one of 50] of the control subjects. The antibiotic, incriminated most frequently, are clindamycin [27.3%], cephradine [17.6%], ampicillin [14.3%], and chloramphenicol plus penicillin [12.5%]. All strains of C. Difficile were obtained with the alcohol shock method, while 20% were isolated with the conventional method of direct stool plating on selective media. All isolated strains were sensitive to metronidazole, vancomycin, bacitracin, ampicillin and penicillin G, while most strains were resistant to gentamycin, clindamycin and cephalosporins. The susceptibility of these isolates to a variety of antimicrobial agents provides information that may be of value in assessing the means by which C. Difficile may produce colitis and in selecting appropriate antibiotic therapy for colitis. It might be advisable therefore, to use only a short course of systemic antibiotic prophylaxis, and to avoid non-absorbable oral antimicrobials