Mechanisms and management of antibiotic-associated diarrhea

被引:226
作者
Högenauer, C [1 ]
Hammer, HF [1 ]
Krejs, GJ [1 ]
Reisinger, EC [1 ]
机构
[1] Karl Franzens Univ Graz, Dept Internal Med, A-8010 Graz, Austria
关键词
D O I
10.1086/514958
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Only 10%-20% of all cases of antibiotic-associated diarrhea (AAD) are caused by infection with Clostridium difficile. Other infectious organisms causing AAD include Clostridium perfringens, Staphylococcus aureus, Klebsiella oxytoca, Candida species, and Salmonella species. Most of the clinically mild AAD cases are due to functional disturbances of intestinal carbohydrate or bile acid metabolism, to allergic and toxic effects of antibiotics on intestinal mucosa, or to pharmacological effects on motility. Saccharomyces boulardii and Enterococcus SF68 can reduce the risk of developing AAD. Patients receiving antibiotic treatment should avoid food containing high amounts of poorly absorbable carbohydrates. Mild cases of AAD that may or may not be caused by C. difficile can be resolved by discontinuation of antibiotic therapy and by dietary carbohydrate reduction. Only severe AAD caused by C. difficile requires specific antibiotic treatment.
引用
收藏
页码:702 / 710
页数:9
相关论文
共 90 条
[1]  
ANAND A, 1994, AM J GASTROENTEROL, V89, P519
[2]  
[Anonymous], MANUAL CLIN MICROBIO
[3]   Management of Clostridium difficile infection and other antibiotic-associated diarrhoeas [J].
Bartlett, JG .
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 1996, 8 (11) :1054-1061
[4]   ANTIBIOTIC-ASSOCIATED DIARRHEA [J].
BARTLETT, JG .
CLINICAL INFECTIOUS DISEASES, 1992, 15 (04) :573-581
[5]   IS CLOSTRIDIUM DIFFICILE ENDEMIC IN CHRONIC-CARE FACILITIES [J].
BENDER, BS ;
LAUGHON, BE ;
GAYDOS, C ;
FORMAN, MS ;
BENNETT, R ;
GREENOUGH, WB ;
SEARS, SD ;
BARTLETT, JG .
LANCET, 1986, 2 (8497) :11-13
[6]  
BENOIT R, 1992, GASTROEN CLIN BIOL, V16, P860
[7]  
BENZ C, 1994, LEBER MAGEN DARM, V24, P171
[8]   7 alpha-dehydroxylating bacteria enhance deoxycholic acid input and cholesterol saturation of bile in patients with gallstones [J].
Berr, F ;
KullakUblick, GA ;
Paumgartner, G ;
Munzing, W ;
Hylemon, PB .
GASTROENTEROLOGY, 1996, 111 (06) :1611-1620
[9]  
BESNARD M, 1993, BONE MARROW TRANSPL, V11, P465
[10]   INFLUENCE OF 3 ANTI-MICROBIAL AGENTS - PENICILLIN, METRONIDAZOLE, AND DOXYCYCLIN - ON THE INTESTINAL MICROFLORA OF HEALTHY HUMANS [J].
BJORNEKLETT, A ;
MIDTVEDT, T .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 1981, 16 (04) :473-480