抗生物質起因性大腸炎６例の検討

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  • A clinical study on six cases of antibiotic-associated colitis.

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Six cases of antibiotic-associated colitis, one of pseudomembranous colitis (PMC) and 5 of acute hemorrhagic colitis (AHC), were observed from March 1982 to February 1983. The age range was from 13 to 58 years (mean 38.2) and sex ratio was 2 to 1 with male preponderance. Antibacterial agents used were amoxicillin (3 cases), ampicillin, cefotiam and combination of cef oxitin and cef actor. These drugs were prescribed for cystitis, pneumonia, common cold, tonsillitis and prophylaxis (2 cases). Main symptoms were diarrhea, abdominal pain and bloody stool. The diarrhea appeared 10.7±6.3 days (range 4-23) after the initiation of antibiotic therapy. Clostridium difficile was detected in stool specimen from PMC and Klebsiella oxytoca from 2 of 5 AHC. Endoscopically, there were yellowish-white, plaque-like lesions with intervening areas of edematous mucosa in the cecum and ascending colon of PMC and the mucosal redness, edema, erosion and bleeding mainly in the rectum and sigmoid colon of 5 AHC cases. All of the patients were completely cured with cessetion of the antibiotics by 6.2 ± 3.7 days (range 3-14). Colonoscopy was a useful procedure for diagnosis of the antibiotic associated colitis and early withdrawal of causative agents led to prompt subsidence.

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