Varughese Christy A, Vakil Niyati H, Phillips Kristy M
Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA.
J Pharm Pract. 2013 Oct;26(5):476-82. doi: 10.1177/0897190013499523.
Antibiotic-associated diarrhea (AAD) describes any unexplained diarrhea associated with the use of an antibiotic. AAD also includes infection caused by Clostridium difficile, however this organism only accounts for a small percentage of diarrhea caused by antibiotics. AAD can be caused by multiple other organisms including C perfringens, S aureus, and Candida. Some antibiotics are more likely to cause non-C difficile AAD, such as erythromycin and the penicillin class. AAD develops through the loss of normal flora and reduced colonic bacterial carbohydrate metabolism during antibiotic administration. There is an increasing interest in the use of probiotics for the prevention of AAD. There are several meta-analyses that report a relative risk reduction of AAD with the use of probiotics during antibiotic administration. Interpretation of these studies has been challenging due to the heterogeneity and size of the patient populations, unclear probiotic regimen, and unclear safety profile. Since AAD can be a reason for a patient to become non-compliant or receive incomplete treatment, clinicians should monitor for this potential adverse effect caused by antibiotics.
抗生素相关性腹泻（AAD）指与使用抗生素相关的任何不明原因的腹泻。AAD还包括艰难梭菌引起的感染，不过该病原体仅占抗生素所致腹泻的一小部分。AAD可由多种其他病原体引起，包括产气荚膜梭菌、金黄色葡萄球菌和念珠菌。一些抗生素更易引起非艰难梭菌性AAD，如红霉素和青霉素类。在使用抗生素期间，AAD通过正常菌群的丧失和结肠细菌碳水化合物代谢的减少而发生。人们对使用益生菌预防AAD的兴趣日益增加。有几项荟萃分析报告称，在使用抗生素期间使用益生菌可降低AAD的相对风险。由于患者群体的异质性和规模、益生菌方案不明确以及安全性概况不明确，对这些研究的解读具有挑战性。由于AAD可能是患者不依从治疗或接受不完全治疗的原因，临床医生应监测这种由抗生素引起的潜在不良反应。
