Andrejak M, Lafon B, Decocq G, Chetaille E, Dupas J L, Ducroix J P, Capron J P
Service de Pharmacologie Clinique, CHU Sud, Amiens, France.
Therapie. 1996 Jan-Feb;51(1):81-6.
Pseudomembranous colitis (PMC) is a rare but potentially severe complication of antibiotic treatment, which is characterized by the proliferation of the bacterium Clostridium difficile in the colon. In this retrospective study, 48 cases of endoscopically confirmed PMC were included. The following variables were analysed: characteristics of the patients, antibiotics, clinical, biological and endoscopic features of PMC and its treatment. The antibiotic treatment was often ambulatory (83 per cent) for a broncho-pulmonary infection (42 per cent). In 90 per cent of the cases, the treatment included a -lactam, frequently amoxicillin with clavulanic acid, and in 25 per cent of the cases, a fluoroquinolone. The PMC generally occurred after more than 4 days of treatment and was associated with diarrhoea, abdominal pain, fever and rarely vomiting (23 per cent). The complications were hypokalaemia (37 per cent), renal failure (27 per cent) and/or hypoproteinaemia (50 per cent). Pseumembranes were found between the rectum and the left angle of the colon. All patients recovered after one week of oral treatment with metronidazole and/or vancomycin, often in association with Saccharomyces boulardii.
伪膜性结肠炎（PMC）是抗生素治疗罕见但潜在严重的并发症，其特征为结肠中艰难梭菌的增殖。在这项回顾性研究中，纳入了48例经内镜确诊的PMC病例。分析了以下变量：患者特征、抗生素、PMC的临床、生物学和内镜特征及其治疗。抗生素治疗常为门诊治疗（83%），用于支气管肺部感染（42%）。在90%的病例中，治疗包括一种β-内酰胺类药物，常为阿莫西林克拉维酸，25%的病例中使用氟喹诺酮类药物。PMC一般在治疗4天以上后发生，与腹泻、腹痛、发热相关，很少有呕吐（23%）。并发症有低钾血症（37%）、肾衰竭（27%）和/或低蛋白血症（50%）。在直肠与结肠左角之间发现伪膜。所有患者经甲硝唑和/或万古霉素口服治疗一周后康复，常联合布拉酵母菌。
