1979 Volume 21 Issue 2 Pages 208-217_1
Six cases of antibiotic-induced colitis have been described; Case 1, 28-year-old man was treated with Ampicillin 1500mg orally for five days as therapy of polysinuectomy. On the seventh day of this therapy, lower abdominal pain, diarrhea and bloody stool developed. Colonoscopy revealed non specific inflammatory changes of the colon. Case 2, 45-year-old man received Lincomycin (600mg, i.m., for a day), Clindamycim (900mg, orally, for two days), and Cephalexin (lg, orally, for nine days) because of cholecyslitis. Diarrhea and bloody stool developed after six days of administration of Cephalexin. Colonoscopy diagnosed of aphtoid colitis. Case 3, 30-year-old woman underwent curretage of placenta accreta and received oral administration of Ampicillin lg daily. Five days after the beginning of therapy, diarrhea and bloody stool were noted. Colonoscopy revealed aphtoid colitis. Case 4, 30-year-old man was diagnosed of malignant lymphoma. Oral administration of Ampicillin, 1500mg per day was recommended under diagnosis of acute bronchitis. Five days after the beginning of therapy, lower abdominal pain, bloody stool, and diarrhea were seen. Colonoscopy showed diffuse redness and localized erosion. Case 5, 55-year-old woman was diagnosed of alveolar abscess, receiving Dibekacin Sulfate (100mg, i.m., for 6 days), Ampicillin (lg, orally, for 6 days), One week after this treatment, lower abdominal pain, waterly diarrhea, and bloody stool happened. Colonoscopy revealed erythematous macule, scattering at the recto-sigmoid colon. Lymphocyte transformation to several antibiotics showed elevated stimulation indices with Ampcillin. Case 6, 71-year-old woman was stung by an insect and received Cephalexin lg orally. Severe diarrhea, low grade fever, and lower abdominal pain developed from the following day. Colonscopy revealed aphtoid colitis. Drug-induced colitis is well known as a type of pseudomembranous colitis. None of our cases led to pseudomembrane formation. With the discontinuation of etiologic agents, all the cases were convalescing satisfactorily. Although colonoscopy revealed various types of colitis, particularly three out of six showed a finding of "aphtoid colitis." Much attention should be paid to the complication at the time of antibiotic therapy, particularly upon colitis in the gastro-enterological field. Therefore, the antibiotic must be ceased immediately when the sign suspectively accompanied with colitis is noted during the administration of antibiotics. Colonoscopic examination is useful to learn both of the spread and the nature of this disease.
