Antibiotic-Associated Colitis

Antibiotic-associated colitis, also known as antibiotic-associated diarrhea or Clostridioides difficile infection (CDI), is a type of colitis that occurs when the use of antibiotics disrupts the normal balance of gut bacteria, leading to an overgrowth of harmful bacteria.

Causes and Risk Factors

The primary cause of antibiotic-associated colitis is the use of broad-spectrum antibiotics, which can alter the normal flora of the gut. This allows harmful bacteria, such as Clostridioides difficile (C. diff), to overgrow and produce toxins that damage the lining of the colon.

Risk factors for developing antibiotic-associated colitis include:

• Recent use of broad-spectrum antibiotics
• Age 65 or older
• Weakened immune system
• Prolonged hospital stay
• Underlying medical conditions, such as inflammatory bowel disease

Symptoms

Symptoms of antibiotic-associated colitis may range from mild to severe and include:

• Diarrhea (watery or bloody)
• Abdominal pain or cramping
• Nausea and vomiting
• Fever
• Loss of appetite
• Weight loss

Diagnosis

Diagnosis of antibiotic-associated colitis is typically made through a combination of:

• Medical history and physical examination
• Stool tests to detect the presence of C. diff toxins or bacteria
• Endoscopy or colonoscopy to visualize the colon and collect tissue samples
• Imaging studies, such as CT scans or X-rays, to rule out other conditions

Treatment

Treatment for antibiotic-associated colitis typically involves:

• Discontinuing the use of broad-spectrum antibiotics
• Antibiotic therapy specifically targeted at C. diff, such as vancomycin or fidaxomicin
• Supportive care, including fluid and electrolyte replacement, to manage symptoms
• Fecal microbiota transplantation (FMT) in severe or recurrent cases

Prevention

To reduce the risk of developing antibiotic-associated colitis, it is essential to:

• Use antibiotics judiciously and only when necessary
• Practice good hygiene, including hand washing and proper cleaning of surfaces
• Avoid close contact with individuals who have CDI
• Follow proper infection control protocols in healthcare settings

Complications

If left untreated or poorly managed, antibiotic-associated colitis can lead to complications such as:

• Toxic megacolon
• Bowel perforation
• Sepsis
• Death