Antibiotic-associated diarrhea

Differential Diagnosis

• Clostridioides difficile
• Other microbes: Clostridium perfringens type A (food poisoning), Staphylococcus aureus, Salmonella enterica, and possible Candida albicans
• Direct effects on intestinal tract
  • Erythromycin and clavulanate cause increased motility
  • Penicillins may rarely cause a segmental colitis
• Effects on the fecal microbiota
  • Decreased carbohydrate metabolism, leading to osmotic diarrhea
  • Breakdown of primary bile acids, leading to secretory diarrhea
• Concomitant use of laxatives, antacids, contrast, lactose- or sorbitol-containing products, NSAIDs, antiarrhythmic drugs, and cholinergic drugs