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Clostridioides difficile, also known more commonly as C. diff, accounts for 10 to 20% of antibiotic-associated diarrhea cases, because the antibiotics administered for the treatment of certain disease processes such as inflammatory colitis also inadvertently kill a large portion of the gut flora, the normal flora that is usually present within the bowel.
It is also one of the medications that can cause toxic epidermal necrolysis or Stevens–Johnson syndrome. [8] The pediatric version of cefdinir can bind to iron in the digestive tract; in rare cases, this causes rust or red discoloration of the stool. Blood typically appears dark brown or black in stool, and testing may confirm which is present.
Decreasing intestinal motility prolongs the transit time of food content through the digestive tract, which allows for more fluid absorption; thereby alleviating diarrhea symptoms and improving stool consistency and frequency. [4] Unlike other opiates, loperamide does not cross the blood brain barrier, so there is minimal risk for abuse. [5]
While medications used to decrease diarrhea such as loperamide are not recommended on their own, they may be used together with antibiotics. [ 11 ] [ 4 ] Shigella results in about 165 million cases of diarrhea and 1.1 million deaths a year with nearly all cases in the developing world. [ 5 ]
Antibiotics can also cause diarrhea, and antibiotic-associated diarrhea is the most common adverse effect of treatment with general antibiotics. While bismuth compounds ( Pepto-Bismol ) decreased the number of bowel movements in those with travelers' diarrhea, they do not decrease the length of illness. [ 112 ]
Treatment strategies should focus on identifying and correcting the root causes, where possible, resolving nutritional deficiencies, and administering antibiotics. This is especially important for patients with indigestion and malabsorption. [4] Although whether antibiotics should be a first line treatment is a matter of debate.