Abstract
This paper presents clinical and endoscopical features of 9 patiens with drug associated colitis. All of the patients were female and they were between 29 and 64 years of age. Anti-bacterial agents used were LCM, TC, CET, PA, CEX and ABPC. These drugs were pre-scribed for reasons of following conditions; prophylactically after opertion (4 cases), otitis media (2 cases), upper respiratory infection (3 cases) . The risk of developing colitis for an individual receiving antibacterial agent does not appear to be dose-dependent nor to be related to the route of administration. The most common symptoms were diarrhea, abdominal pain and fever. The interval from initiation of antibiotic therapy to the onset of diarrhea was from 2 to 15 days. All of the patients got well both clinically and colonoscopically by 11-- 49 days after the onset of diarrhea. No patient had spontaneous relapse of colitis any more. Pathogenic bacteria were not noticed in spite of repeated stool culture of all cases. Case (3) and (A) had positive lymphocyte stimulation test. Colonoscopy was the most useful examination in evaluating the disease. Two cases had pseudomembraneous colitis, and the others had a colitis with mucosal redness, erosion, edema and bleeding. The finding of pseudomembranes seemed to indicate a worse outcome. Generally speaking, patients receiving antibacterial agent should be carefully checked for the development of diarrhea. If diarrhea developes, a colonoscopic examination should be performed promptly. Once colitis is found, the antibacterial agent should be immediately discontinued. An energetic supportive therapy should be done especially in case of pseudo-membraneous colitis.
