Antibiotics: How They Cause Diarrhea

[Sangye]

This is an interesting article from a JHU newsletter. Here's the link, and here's the text of it:

How Antibiotics Work. Many different species of bacteria live in your digestive tract. Most are helpful, others are harmful, but in healthy people the good bacteria far outnumber the bad. This balance is delicate, however, and it can be easily disrupted.

When you take an antibiotic for an infection, it doesn't just target the problem bacteria. The antibiotic can kill off both good and bad bacteria in your digestive tract. Often the strongest, most treatment-resistant harmful bacteria are the ones that remain, and as they're allowed to multiply unchecked they can wreak havoc on your digestive system.

Most people taking an antibiotic will be fine, but the accompanying diarrhea that affects the other 20 percent can range from a mild, short-lived bout of diarrhea to colitis, an inflammation of the colon. Some people may experience a more serious, perhaps even life-threatening, form of colitis caused by the bacterium Clostridium difficile (C. difficile).

People over age 65 are more prone to develop antibiotic-associated diarrhea (AAD) and colitis, as are those who have recently stayed in a hospital or nursing home, have had surgery on the intestinal tract or have another illness affecting the intestines, such as inflammatory bowel disease or colon cancer.

While any antibiotic, oral or injected, has the potential to cause diarrhea, the most likely candidates are stronger, broad-spectrum antibiotics, which include:

• cephalosporins like cefixime (Suprax) and cefpodoxime (Vantin)
• extended-coverage penicillins like amoxicillin
• erythromycin
• quinolones such as ciprofloxacin (Cipro) and levofloxacin (Levaquin)
• tetracyclines
• clindamycin

Antibiotic-associated diarrhea (AAD) involves occasional loose stools or mild diarrhea for several days. The problem typically begins five to 10 days after starting an antibiotic; however, in 25 to 40 percent of cases, symptoms don't appear until up to 10 weeks after treatment ends. Most cases of AAD do not require treatment and will resolve on their own within two weeks after finishing an antibiotic.

[pberggren1]

I have been on all of those antibiotics. YIKES!!!!

[norcalian]

Thanks for posting that article. I still have diarrhea since the hospital. C. Difficile was the first thing my rheumy tested me for. Fortunately the test was negative. I've been trying to eat more probiotics...I wonder if its from the pred indigestion...

Anyway, interesting info.

[delorisdoe]

I have also found that a combination of 3 antibiotics only one of which is mentioned above is great for diarreah.

[Sangye]

norcalian, make sure you're taking a good probiotic. Many OTC probiotics do not contain the number of live cultures they claim to. PB-8 makes a good one--mid-priced, easy to find in health food stores, reliable active cultures. You don't need the fanciest, most expensive ones with other ingredients.

You need to make sure you take enough (at least 5-7 billion units a day) and take them away from food. Bedtime is great if you don't take other meds. Otherwise, take them in the middle of the night if you get up to pee. After being on any antibiotic, you should stay on daily probiotics for at least 6 weeks. If you're on the prophylactic dose of Bactrim, you should stay on probiotics indefinitely.

[julia]

Did I miss something? I find it difficult to navigate this site lately.
Just wondering.