sultamicillin and Enterocolitis--Pseudomembranous

Antibiotic-associated hemorrhagic colitis is a distinct form of antibiotic-associated bloody diarrhea (AABD) in which Clostridium difficile is absent. Although the cause is not exactly known, reports have suggested the role of Klebsiella oxytoca and/or C. difficile.. Between 2001 and 2006, stool samples of 21 consecutive patients with AABD were cultured for common enteric pathogens and K. oxytoca, and were tested for the presence of parasites and C. difficile toxin A+B within the first 24 h of their initial admission and a colonoscopy was performed when available. The patients were followed up prospectively by telephone interviews.. The occurrence of symptoms ranged between 6 h and 14 days following the first dose of the antibiotic responsible and the duration of the AABD ranged between 6 h and 21 days. The antibiotic responsible was oral ampicillin/sulbactam in 18 (85%) cases. C. difficile toxin A+B production by enzyme-linked immunosorbent assay and K. oxytoca growth in stool cultures were detected in six (29%) and 11 (51%) of 21 patients, respectively. Endoscopic morphology and histology in a limited number of patients revealed no more than a nonspecific inflammation and acute colitis, respectively.. This study confirms that antibiotic-associated hemorrhagic colitis, as a distinct entity in relation to K. oxytoca, is seen in half of the patients with AABD. Most of the cases are seen within a week following the antibiotic use. Almost all of the patients did not develop any flares during the long-term antibiotic-free follow-up. In some of the patients with AABD, there was coexistence of K. oxytoca with C. difficile toxin A+B.

Topics: Adult; Ampicillin; Anti-Bacterial Agents; Bacterial Toxins; Clostridioides difficile; Colonoscopy; Diarrhea; Enterocolitis, Pseudomembranous; Enterotoxins; Feces; Female; Follow-Up Studies; Humans; Klebsiella Infections; Klebsiella oxytoca; Male; Middle Aged; Prospective Studies; Sulbactam; Young Adult

A 55-year-old man presented with a 12-pound weight loss and acute diarrhea. He had had three watery stools a day for 12 days, as well as fever, chills, abdominal pain, nausea, and vomiting. He had not had any bowel movements at night, but noted that the first one each morning was tinged with blood.

Topics: Aeromonas hydrophila; Ampicillin; Diagnosis, Differential; Drug Therapy, Combination; Enterocolitis, Pseudomembranous; Humans; Intestinal Obstruction; Male; Metronidazole; Middle Aged; Sulbactam

Topics: Ampicillin; Colonoscopy; Drug Therapy, Combination; Enterocolitis, Pseudomembranous; Female; Glucocorticoids; Humans; Middle Aged; Pemphigus; Prednisolone; Sulbactam

We describe nine children with antibiotic-associated hemorrhagic colitis without Clostridium difficile toxin. The onset was usually sudden, with severe hematochezia and abdominal cramps. The illness quickly resolved and required no specific treatment except discontinuation of the implicated antibiotic. Early proctosigmoidoscopy was a useful diagnostic adjunct. It appears that antibiotic-associated hemorrhagic colitis is a distinct entity rather than a variant of antibiotic-associated colitis in children.

Topics: Adolescent; Amoxicillin; Ampicillin; Anti-Bacterial Agents; Cefdinir; Cephalosporins; Child; Child, Preschool; Colitis; Enterocolitis, Pseudomembranous; Female; Gastrointestinal Hemorrhage; Humans; Male; Retrospective Studies; Sulbactam