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Journal articles on the topic 'Antibiotic-associated diarrhoea'

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Published: 10 December 2022

Last updated: 29 January 2023

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1

Overeem, Karlijn, Geertje van Soest, and Nettie Blankenstein. "Antibiotic-associated diarrhoea." British Journal of General Practice 58, no. 549 (April 1, 2008): 283.3–284. http://dx.doi.org/10.3399/bjgp08x279959.

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2

Garg, Ritu, and Varsha Gupta. "Antibiotic associated diarrhoea." Journal of Gastrointestinal Infections 3, no. 1 (July 2012): 6–8. http://dx.doi.org/10.5005/jogi-3-1-6.

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3

Riley, Thomas V. "Antibiotic-Associated Diarrhoea." PharmacoEconomics 10, no. 1 (July 1996): 1–3. http://dx.doi.org/10.2165/00019053-199610010-00001.

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4

Hancock, Paul. "Antibiotic-associated diarrhoea." Reviews in Medical Microbiology 8 (1997): S69. http://dx.doi.org/10.1097/00013542-199712001-00038.

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5

Coté, Gregory A., and Alan L. Buchman. "Antibiotic-associated diarrhoea." Expert Opinion on Drug Safety 5, no. 3 (April 13, 2006): 361–72. http://dx.doi.org/10.1517/14740338.5.3.361.

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6

Martínez, Esteban, and Angeles Marcos. "Antibiotic-associated diarrhoea." Lancet 337, no. 8746 (April 1991): 911. http://dx.doi.org/10.1016/0140-6736(91)90238-k.

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7

Beaugerie, Laurent, and Jean-Claude Petit. "Antibiotic-associated diarrhoea." Best Practice & Research Clinical Gastroenterology 18, no. 2 (April 2004): 337–52. http://dx.doi.org/10.1016/j.bpg.2003.10.002.

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8

Barbut, F. "Managing antibiotic associated diarrhoea." BMJ 324, no. 7350 (June 8, 2002): 1345–46. http://dx.doi.org/10.1136/bmj.324.7350.1345.

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9

Gustafsson, A. "Antibiotic-associated diarrhoea in horses." Equine Veterinary Education 14, no. 4 (January 5, 2010): 186. http://dx.doi.org/10.1111/j.2042-3292.2002.tb00168.x.

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10

McFarland, Lynne V. "Diarrhoea associated with antibiotic use." BMJ 335, no. 7610 (July 12, 2007): 54–55. http://dx.doi.org/10.1136/bmj.39255.829120.47.

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11

Battle, M. "Probiotics and antibiotic associated diarrhoea." BMJ 325, no. 7369 (October 19, 2002): 901b—901. http://dx.doi.org/10.1136/bmj.325.7369.901/b.

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12

Krause, R., and E. C. Reisinger. "Candida and antibiotic-associated diarrhoea." Clinical Microbiology and Infection 11, no. 1 (January 2005): 1–2. http://dx.doi.org/10.1111/j.1469-0691.2004.00978.x.

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13

Cremonini, F., S. Di Caro, L. Santarelli, M. Gabrielli, M. Candelli, E. C. Nista, A. Lupascu, G. Gasbarrini, and A. Gasbarrini. "Probiotics in antibiotic-associated diarrhoea." Digestive and Liver Disease 34 (September 2002): S78—S80. http://dx.doi.org/10.1016/s1590-8658(02)80171-2.

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14

Kogan, Mikhail. "Probiotics and antibiotic-associated diarrhoea." Lancet 383, no. 9911 (January 2014): 29. http://dx.doi.org/10.1016/s0140-6736(13)62733-6.

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Kalil, Andre C., and Trevor C. Schooneveld. "Probiotics and antibiotic-associated diarrhoea." Lancet 383, no. 9911 (January 2014): 29–30. http://dx.doi.org/10.1016/s0140-6736(13)62734-8.

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16

Loy, C. E. "Antibiotic-associated diarrhoea: an overlooked aetiology?" British Journal of Biomedical Science 62, no. 4 (January 2005): 166–69. http://dx.doi.org/10.1080/09674845.2005.11732705.

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17

Hood, Kerenza, Jacqui Nuttall, David Gillespie, Victoria Shepherd, Fiona Wood, Donna Duncan, Helen Stanton, et al. "Probiotics for Antibiotic-Associated Diarrhoea (PAAD): a prospective observational study of antibiotic-associated diarrhoea (including Clostridium difficile-associated diarrhoea) in care homes." Health Technology Assessment 18, no. 63 (October 2014): 1–84. http://dx.doi.org/10.3310/hta18630.

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BackgroundAntibiotic prescribing rates in care homes are higher than in the general population. Antibiotics disrupt the normal gut flora, sometimes causing antibiotic-associated diarrhoea (AAD).Clostridium difficile(Hall and O’Toole 1935) Prévot 1938 is the most commonly identified cause of AAD. Little is known either about the frequency or type of antibiotics prescribed in care homes or about the incidence and aetiology of AAD in this setting.ObjectivesThe Probiotics for Antibiotic-Associated Diarrhoea (PAAD) study was designed as a two-stage study. PAAD stage 1 aimed to (1) prospectively describe antibiotic prescribing in care homes; (2) determine the incidence ofC. difficilecarriage and AAD (includingC. difficile-associated diarrhoea); and (3) to consider implementation challenges and establish the basis for a sample size estimation for a randomised controlled trial (RCT) of probiotic administration with antibiotics to prevent AAD in care homes. If justified by PAAD stage 1, the RCT would be implemented in PAAD stage 2. However, as a result of new evidence regarding the clinical effectiveness of probiotics on the incidence of AAD, a decision was taken not to proceed with PAAD stage 2.DesignPAAD stage 1 was a prospective observational cohort study in care homes in South Wales with up to 12 months’ follow-up for each resident.SettingRecruited care homes had management and owner’s agreement to participate and three or more staff willing to take responsibility for implementing the study.ParticipantsEleven care homes were recruited, but one withdrew before any residents were recruited. A total of 279 care home residents were recruited to the observational study and 19 withdrew, 16 (84%) because of moving to a non-participating care home.Main outcome measuresThe primary outcomes were the rate of antibiotic prescribing, incidence of AAD, defined as three or more loose stools (type 5–7 on the Bristol Stool Chart) in a 24-hour period, andC. difficilecarriage confirmed on stool culture.ResultsStool samples were obtained at study entry from 81% of participating residents. Over half of the samples contained antibiotic-resistant isolates, with Enterobacteriaceae resistant to ciprofloxacin in 47%. Residents were prescribed an average of 2.16 antibiotic prescriptions per year [95% confidence interval (CI) 1.90 to 2.46]. Antibiotics were less likely to be prescribed to residents from dual-registered homes. The incidence of AAD was 0.57 (95% CI 0.41 to 0.81) episodes per year among those residents who were prescribed antibiotics. AAD was more likely in residents who were prescribed co-amoxiclav than other antibiotics and in those residents who routinely used incontinence pads. AAD was less common in residents from residential homes.ConclusionsCare home residents, particularly in nursing homes, are frequently prescribed antibiotics and often experience AAD. Antibiotic resistance, including ciprofloxacin resistance, is common in Enterobacteriaceae isolated from the stool of care home residents. Co-amoxiclav is associated with greater risk of AAD than other commonly prescribed antibiotics.Trial registrationCurrent Controlled Trials ISRCTN 7954844.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 18, No. 63. See the NIHR Journals Library website for further project information.

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18

Surawicz, Christina M. "Probiotics, antibiotic-associated diarrhoea and Clostridium difficile diarrhoea in humans." Best Practice & Research Clinical Gastroenterology 17, no. 5 (October 2003): 775–83. http://dx.doi.org/10.1016/s1521-6918(03)00054-4.

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19

Al-Ghamdi, Hamed, Maram Alaofi, Ali Al Dughman, Khalid Aldawsari, Theyab Alghamdi, Ohud Althagafi, Mohammad Alghanem, et al. "Impact of Concurrent Use of Probiotics on Risk of Antibiotic Associated Diarrhoea in Adults." Journal of Healthcare Sciences 02, no. 09 (2022): 219–24. http://dx.doi.org/10.52533/johs.2022.2902.

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Antibiotics are one of the most prescribed medications worldwide. It is given to treat a wide range of infections and diseases. However, usage of antibiotics is associated with several side effects. The most frequently reported side effect is diarrhoea since antibiotics affect the gastrointestinal microbial environment. Antibiotic associated diarrhoea refers to the diarrhoea that develops at the initiation of the antibiotic therapy and can extend even up to six or more weeks after termination of the therapy. The prevalence of antibiotic associated diarrhoea ranges from 5% to 39% and is associated with significant morbidity and mortality. Antibiotic associated diarrhoea can be caused by any antibiotic used although the risk is higher for broad-spectrum antibiotics since they primarily target anaerobes and are poorly absorbed. Probiotics aid in reducing the risk of antibiotic associated diarrhoea. The purpose of this research is to review the available information about the impact of concurrent use of probiotics on risk of antibiotic-associated diarrhoea in adults. Various studies in the literature suggest of concurrent use of probiotics in treatment and prevention of antibiotic associated diarrhoea. Probiotics have been widely recommended as a robust and reliable strategy to lessen the negative effects of antibiotics on gastrointestinal function. Probiotics have a beneficial role in improving the gut health thus lowering the incidence of antibiotic associated diarrhoea if administered concurrently. Probiotics are generally well-tolerated and have minimum side effects. However more clinical research is needed to establish the guidelines for their concurrent use with antibiotic therapy to prevent antibiotic associated diarrhoea.

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Anumolu, Srimukhi, Gowri Edagotti, and M. A. Rahman. "Antibiotic associated diarrhoea in paediatric outpatient practice." International Journal of Contemporary Pediatrics 8, no. 3 (February 23, 2021): 541. http://dx.doi.org/10.18203/2349-3291.ijcp20210660.

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Background: To document the profile of antibiotic associated diarrhoea (AAD) in children aged 6 months to 15 years receiving oral antibiotics.Methods: Prospective study of children attending the out-patient department, who were started on oral antibiotic for indications other than gastrointestinal infections. Data collection was done with a questionnaire and follow up was done by telephone.Results: Of the 1022 children, seven developed AAD (0.68%). Twenty-nine other children had loose stools but did not fulfil the criteria of AAD. Of 436 children who received Amoxicillin clavulanate, 4 developed AAD. One each from 361 on amoxicillin, 9 on ciprofloxacin and 8 on erythromycin developed AAD. Five of the seven children who had diarrhoea were less than two years (71.4%).Conclusions: Incidence of AAD is very low in an out-patient setting. In all cases, diarrhoea subsided on stopping the antibiotic. Children below two years of age and those on Amoxicillin clavulanate have a significantly higher risk.

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21

Doszyń, Anna, and Magdalena Dubińska. "Clostridium perfringens may cause antibiotic -associated diarrhoea." Forum Zakażeń 5, no. 5 (October 20, 2014): 303–6. http://dx.doi.org/10.15374/fz2014054.

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22

Mullish, Benjamin H., and Horace RT Williams. "Clostridium difficile infection and antibiotic-associated diarrhoea." Clinical Medicine 18, no. 3 (June 2018): 237–41. http://dx.doi.org/10.7861/clinmedicine.18-3-237.

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23

Videlock, E. J., and F. Cremonini. "Meta-analysis: probiotics in antibiotic-associated diarrhoea." Alimentary Pharmacology & Therapeutics 35, no. 12 (April 24, 2012): 1355–69. http://dx.doi.org/10.1111/j.1365-2036.2012.05104.x.

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24

Allen, Stephen J., Michael B. Gravenor, Kathie Wareham, and Duolao Wang. "Probiotics and antibiotic-associated diarrhoea – Authors' reply." Lancet 383, no. 9911 (January 2014): 30. http://dx.doi.org/10.1016/s0140-6736(13)62735-x.

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25

Gould, K., and G. Short. "Probiotics and antibiotic-associated diarrhoea--a logical flaw?" Journal of Antimicrobial Chemotherapy 61, no. 3 (February 4, 2008): 761. http://dx.doi.org/10.1093/jac/dkm534.

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26

Erdeve, O., U. Tiras, Y. Dallar, and S. Savas. "Saccharomyces boulardii and antibiotic-associated diarrhoea in children." Alimentary Pharmacology and Therapeutics 21, no. 12 (June 2005): 1508–9. http://dx.doi.org/10.1111/j.1365-2036.2005.02498.x.

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27

ASHA, N. J., and M. H. WILCOX. "Laboratory diagnosis of Clostridium perfringens antibiotic-associated diarrhoea." Journal of Medical Microbiology 51, no. 10 (October 1, 2002): 891–94. http://dx.doi.org/10.1099/0022-1317-51-10-891.

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28

Roberts, H. "Letter. Antibiotic policies and Clostridium difficile-associated diarrhoea." Age and Ageing 29, no. 4 (July 1, 2000): 369a—369. http://dx.doi.org/10.1093/ageing/29.4.369a.

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29

HARAN, J. P., G. WU, V. BUCCI, A. FISCHER, L. KEANG, E. W. BOYER, and P. L. HIBBERD. "Antibiotic-associated diarrhoea in emergency department observation unit patients." Epidemiology and Infection 144, no. 10 (February 15, 2016): 2176–83. http://dx.doi.org/10.1017/s0950268816000200.

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SUMMARYClostridium difficile diarrhoea is an urgent threat to patients, but little is known about the role of antibiotic administration that starts in emergency department observation units (EDOUs). We studied risk factors for antibiotic-associated diarrhoea (AAD) and C. difficile infection (CDI) in EDOU patients. This prospective cohort study enrolled adult patients discharged after EDOU antibiotic treatment between January 2013 and 2014. We obtained medical histories, EDOU treatment and occurrence of AAD and CDI over 28 days after discharge. We enrolled and followed 275 patients treated with antibiotics in the EDOU. We found that 52 (18·6%) developed AAD and four (1·5%) had CDI. Patients treated with vancomycin [relative risk (RR) 0·52, 95% confidence interval (CI) 0·3–0·9] were less likely to develop AAD. History of developing diarrhoea with antibiotics (RR 3·11, 95% CI 1·92–5·03) and currently failing antibiotics (RR 1·90, 95% CI 1·14–3·16) were also predictors of AAD. Patients with CDI were likely to be treated with clindamycin. In conclusion, AAD occurred in almost 20% of EDOU patients with risk factors including a previous history of diarrhoea with antibiotics and prior antibiotic therapy, while the risk of AAD was lower in patients receiving treatment regimens utilizing intravenous vancomycin.

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30

Fredua-Agyeman, Mansa, Blessing Onwukwe, and Nii Armah Adu-Aryee. "Antibiotic prescribing and the risk of antibiotic–associated diarrhoea in Korle Bu Teaching Hospital, Ghana: a pilot study." Journal of Infection in Developing Countries 14, no. 08 (August 31, 2020): 861–68. http://dx.doi.org/10.3855/jidc.11259.

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Introduction: This study sought to identify the association of antibiotic prescribing and the risk of antibiotic-associated diarrhoea (AAD) in Korle Bu Teaching Hospital (KBTH) in Ghana. Methodology: Patients from the Male Urology Ward and Treatment Room of the Surgical Department of KBTH were followed up over three months to determine if they had experienced any unusual diarrhoeal illness after antibiotic therapy. 81 eligible patients (adults) were included in the study but a total of 70 patients (mean age of 56.71 years) were successfully followed up during the study period. Results: The top conditions presented by patients were urological infection (66.7%), cancer (15.3%) and leg ulcer (18.1%). Ciprofloxacin (50%) and ceftriaxone (28.5%) were the most prescribed antibiotics. Eleven patients (more than 1 in 7) developed diarrhoea that could be associated with their use of antibiotics. The occurrence of AAD was significantly associated with type of antibiotic used by patient. 73% of patients who developed symptoms of AAD had received Clindamycin. Risk of AAD was not significantly associated with age and comorbidities. Conclusions: The rate of AAD in the Male Urology Ward and the Treatment Room of the Surgical Department of KBTH during the period of this study was 15.7%. Clindamycin was identified as the most implicated antibiotic.

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31

Mateen, Bilal Akhter, Sandip Samanta, Sebastian Tullie, Sarah O’Neill, Zillah Cargill, Gillian Kelly, Ewen Brennan, et al. "Diarrhoea and preadmission antibiotic exposure in COVID-19: a retrospective cohort study of 1153 hospitalised patients." BMJ Open Gastroenterology 8, no. 1 (September 2021): e000593. http://dx.doi.org/10.1136/bmjgast-2020-000593.

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ObjectiveThe aims of this study were to describe community antibiotic prescribing patterns in individuals hospitalised with COVID-19, and to determine the association between experiencing diarrhoea, stratified by preadmission exposure to antibiotics, and mortality risk in this cohort.Design/methodsRetrospective study of the index presentations of 1153 adult patients with COVID-19, admitted between 1 March 2020 and 29 June 2020 in a South London NHS Trust. Data on patients’ medical history (presence of diarrhoea, antibiotic use in the previous 14 days, comorbidities); demographics (age, ethnicity, and body mass index); and blood test results were extracted. Time to event modelling was used to determine the risk of mortality for patients with diarrhoea and/or exposure to antibiotics.Results19.2% of the cohort reported diarrhoea on presentation; these patients tended to be younger, and were less likely to have recent exposure to antibiotics (unadjusted OR 0.64, 95% CI 0.42 to 0.97). 19.1% of the cohort had a course of antibiotics in the 2 weeks preceding admission; this was associated with dementia (unadjusted OR 2.92, 95% CI 1.14 to 7.49). After adjusting for confounders, neither diarrhoea nor recent antibiotic exposure was associated with increased mortality risk. However, the absence of diarrhoea in the presence of recent antibiotic exposure was associated with a 30% increased risk of mortality.ConclusionCommunity antibiotic use in patients with COVID-19, prior to hospitalisation, is relatively common, and absence of diarrhoea in antibiotic-exposed patients may be associated with increased risk of mortality. However, it is unclear whether this represents a causal physiological relationship or residual confounding.

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32

Cremonini, Filippo, and Elizabeth Jane Videlock. "Probiotics are associated with a decreased risk of antibiotic-associated diarrhoea." Evidence Based Medicine 18, no. 2 (August 14, 2012): 71–72. http://dx.doi.org/10.1136/eb-2012-100863.

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33

D'Souza, A. L. "Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis." BMJ 324, no. 7350 (June 8, 2002): 1361. http://dx.doi.org/10.1136/bmj.324.7350.1361.

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34

Harris, A. D. "Review: probiotics are effective in preventing antibiotic-associated diarrhoea." Evidence-Based Medicine 7, no. 6 (November 1, 2002): 184. http://dx.doi.org/10.1136/ebm.7.6.184.

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35

&NA;. "Probiotic drink goes down well in antibiotic-associated diarrhoea." Inpharma Weekly &NA;, no. 1596 (July 2007): 15. http://dx.doi.org/10.2165/00128413-200715960-00030.

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Gagan, M. J. "Review: probiotics are effective in preventing antibiotic associated diarrhoea." Evidence-Based Nursing 6, no. 1 (January 1, 2003): 16. http://dx.doi.org/10.1136/ebn.6.1.16.

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37

Siitonen, Simo, Heikki Vapaatalo, Seppo Salminen, Ariel Gordin, Maija Saxelin, Raija Wikberg, and Anna-Leena Kirkkola. "Effect ofLactobacillusGG Yoghurt in Prevention of Antibiotic Associated Diarrhoea." Annals of Medicine 22, no. 1 (January 1990): 57–59. http://dx.doi.org/10.3109/07853899009147243.

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Lewis, S., S. Burmeister, S. Cohen, J. Brazier, and A. Awasthi. "Failure of dietary oligofructose to prevent antibiotic-associated diarrhoea." Alimentary Pharmacology and Therapeutics 21, no. 4 (February 2005): 469–77. http://dx.doi.org/10.1111/j.1365-2036.2005.02304.x.

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39

Guridi, C. Barreiro, A. Romeo Serena, S. Gallego Cabrera, I. Alaman Fernández, C. Royo Hernández, B. Martín Vivanco, M. Cruz Melguizo, J. Suárez-Almarza, and C. Nieto-Magro. "Clinical evaluation of the synbiotic Prodefen Plus® in the prevention of the antibiotic-associated diarrhoea in subjects requiring antibiotic treatment." Beneficial Microbes 11, no. 6 (October 12, 2020): 535–45. http://dx.doi.org/10.3920/bm2020.0062.

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Prodefen® is a dietary food supplement formulated as a synbiotic that has shown additional benefit to the standard supportive therapy in the management of acute viral diarrhoea in children. There is scarce evidence of this synbiotic in adults. The objective of this randomised double blind placebo-controlled clinical trial was to evaluate the efficacy and safety of Prodefen Plus® in the prevention of antibiotic-associated diarrhoea (AAD) in an adult population requiring either antibiotic treatment for an oral infection or antibiotic prophylaxis for a dental surgical procedure in a dental consultation. 151 subjects were randomised to the active (synbiotic) or control arm (placebo) for 14 days. There was a significantly higher reduction in the AAD incidence, and an improvement in the stool consistency in the active group. A higher reduction in both the frequency and duration of the diarrhoea episodes in the active group was also observed, as it was an improved perception of the diarrhoea severity. Overall, the study medication was well tolerated. In conclusion, results from this study confirm the beneficial effect of the synbiotic administered as adjuvant therapy in preventing the antibiotic-associated diarrhoea.

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Shapovalova, M. M., A. V. Budnevsky, A. Ya Kravchenko, E. S. Drobysheva, and E. S. Ovsyannikov. "PATHOGENESIS, ACTUAL ASPECTS OF PREVENTION AND TREATMENT OF THE ANTIBIOTIC-ASSOCIATED DIARRHOEA." Russian Archives of Internal Medicine 8, no. 6 (December 3, 2018): 424–29. http://dx.doi.org/10.20514/2226-6704-2018-8-6-424-429.

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The article provides an overview of current Russian and foreign literature devoted to the problem of pathogenesis, and of the treatment and prevention of antibiotic-associated diarrhea. Antibiotic-associated diarrhea is one of the most relevant aspects of modern drug therapy in due to the frequent prescription of antibacterial agents. Antibiotic-associated diarrhea (according to WHO) is defined as the presence of three or more episodes of an unformed stool for two or more consecutive days that occurred during or after the end of antibiotic therapy. The risk of developing this disorder is highest when using aminopenicillins, as well as their combinations with clavulanic acid, cephalosporins, clindamycin. Despite the presence of a common etiologic factor — the intake of antibacterial agents, the immediate causes and mechanisms of antibiotic-associated diarrhea development in patients may be different. The article describes the main issues of the etiology and pathogenesis of this pathology, the risk factors for the development of antibiotic-associated diarrhea are named, that allows to predict this complication in certain categories of patients. Тhe virulence factors of Clostridium difficile, Klebsiella oxytoca, Candida spp. and the clinical manifestations associated with their effects are highlighted. The clinical variants of this disease are described: 1) pseudomembranous colitis; 2) segmental hemorrhagic colitis; 3) “mild illness”. Contemporary literature data on the possibilities of prevention, as well as effective methods of treatment of antibiotic-associated diarrhea, are presented. For the treatment and prevention of all clinical forms of antibiotic-associated diarrhea, most authors suggest the use of drugs that make up the deficiency of normal intestinal microbiota — probiotics and prebiotics. The problem of the benefits of adjuvant therapy with probiotics during the course of antibiotics for the prevention of antibiotic-associated diarrhea remains controversial, the effectiveness and safety of the use of various probiotic cultures for this purpose is being studied. The information presented in this review is intended to target physicians to the rational use of antibacterial agents, and to early diagnosis of their most frequent side effect, antibiotic-associated diarrhea.

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Ludlam, H. "An antibiotic policy associated with reduced risk of Clostridium difficile-associated diarrhoea." Age and Ageing 28, no. 6 (October 1, 1999): 578–80. http://dx.doi.org/10.1093/ageing/28.6.578.

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42

Hove, H., M. Tvede, and P. Brøbech Mortensen. "Antibiotic-Associated Diarrhoea,Clostridium difficile, and Short-Chain Fatty Acids." Scandinavian Journal of Gastroenterology 31, no. 7 (January 1996): 688–93. http://dx.doi.org/10.3109/00365529609009151.

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43

Shrestha, Sreska, and Priyatam Khadka. "Neglected Case of Human Balantidiasis: Presumed as Antibiotic-Associated Diarrhoea." Case Reports in Infectious Diseases 2022 (June 13, 2022): 1–4. http://dx.doi.org/10.1155/2022/6013151.

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Background. Balantidiasis, due to its rare human incidence and nonspecific clinical presentations often neglected from the diagnosis considerations; however, a potent pathogen. Herein, we report a case of neglected balantidiasis presumed as antibiotic-associated diarrhoea. Case Presentation. A 27-year-old policeman presented in Sindhuli Hospital, with a chief complaint of epigastric pain, nausea, decreased appetite for several days, and loose stools (3-4 episodes per day). Previously, he was under antibiotic therapy (amoxycillin) for tonsillitis. The health post clinician made a presumptive diagnosis as the side effects of the antibiotics; however, the symptoms were not resolved. Complete blood cell count (CBC) was normal; renal function test (RFT) and liver function (LFT) were within the normal ranges. Ultrasonography of the abdomen and ECG (electrocardiogram) showed normal findings. However, on routine stool actively motile trophozoites of Balantidium coli (B. coli) were seen. He was treated successfully with metronidazole 750 mg tabs orally three times daily for 5 days. Conclusion. Protozoal infections, like balantidiasis, might be excluded from the diagnostic consideration in antibiotic-associated diarrhoea cases. Therefore, meticulous review of nonspecific clinical presentation and validation of an etiology with support of diagnostic tests are mandatory.

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Jindal, Meenakshi, Yogesh Goyal, Suman lata, and Rajeev Kumar Sharma. "Preventive Role of Probiotic in Antibiotic Associated Diarrhoea in Children." Indian Journal of Public Health Research & Development 8, no. 3 (2017): 66. http://dx.doi.org/10.5958/0976-5506.2017.00162.0.

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45

Hickson, Mary. "Probiotics in the prevention of antibiotic-associated diarrhoea andClostridium difficileinfection." Therapeutic Advances in Gastroenterology 4, no. 3 (February 22, 2011): 185–97. http://dx.doi.org/10.1177/1756283x11399115.

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Butler, C. C., D. Duncan, and K. Hood. "Does taking probiotics routinely with antibiotics prevent antibiotic associated diarrhoea?" BMJ 344, feb21 1 (February 21, 2012): e682-e682. http://dx.doi.org/10.1136/bmj.e682.

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Szajewska, H., and M. Kotowska. "Saccharomyces boulardii and antibiotic-associated diarrhoea in children: Author's reply." Alimentary Pharmacology and Therapeutics 21, no. 12 (June 2005): 1509. http://dx.doi.org/10.1111/j.1365-2036.2005.02510.x.

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Beaugerie, L., A. Flahault, F. Barbut, P. Atlan, V. Lalande, P. Cousin, M. Cadilhac, and J. C. Petit. "Antibiotic-associated diarrhoea and Clostridium difficile> in the community." Alimentary Pharmacology & Therapeutics 17, no. 7 (March 26, 2003): 905–12. http://dx.doi.org/10.1046/j.1365-2036.2003.01531.x.

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Wilcox, Mark, and Jane Minton. "Role of antibody response in outcome of antibiotic-associated diarrhoea." Lancet 357, no. 9251 (January 2001): 158–59. http://dx.doi.org/10.1016/s0140-6736(00)03582-0.

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Sanderson, P. J., and S. S. Bukhari. "Candida spp. and Clostridium difficile toxin-negative antibiotic-associated diarrhoea." Journal of Hospital Infection 19, no. 2 (October 1991): 142–43. http://dx.doi.org/10.1016/0195-6701(91)90108-k.

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