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Meta-analyses have concluded that probiotics may protect against antibiotic-associated diarrhea in both children and adults. [2] [3] Evidence is insufficient, however, regarding an effect on rates of C. difficile colitis. [4] The efficacy of probiotic AAD prevention is dependent on the probiotic strain(s) used and on the dosage.
Antibiotics such as azithromycin may be used to treat cases associated with travelling in the developing world. [11] While medications used to decrease diarrhea such as loperamide are not recommended on their own, they may be used together with antibiotics. [11] [4]
Antibiotics with less reliable but occasional (depending on isolate and subspecies) activity: occasionally penicillins including penicillin, ampicillin and ampicillin-sulbactam, amoxicillin and amoxicillin-clavulnate, and piperacillin-tazobactam (not all vancomycin-resistant Enterococcus isolates are resistant to penicillin and ampicillin)
Common side effects of oral antibiotics include diarrhea, resulting from disruption of the species composition in the intestinal flora, resulting, for example, in overgrowth of pathogenic bacteria, such as Clostridioides difficile. [48] Taking probiotics during the course of antibiotic treatment can help prevent antibiotic-associated diarrhea. [49]
Antibiotics are a common treatment for children, with 11% to 40% of antibiotic-treated children developing diarrhea. [94] Antibiotic-associated diarrhea (AAD) results from an imbalance in the colonic microbiota caused by antibiotic therapy. [ 94 ]
Azithromycin is an azalide, a type of macrolide antibiotic. [10] It works by decreasing the production of protein, thereby stopping bacterial growth. [10] [13] Azithromycin was discovered in Yugoslavia (present day Croatia) in 1980 by the pharmaceutical company Pliva and approved for medical use in 1988.
The incubation period is 5–10 days, with a range of 1 day to weeks following antibiotic treatment for antibiotic associated diarrhea. Additionally, carriage of C. difficile with high levels of toxins is common in young children, while disease is rare. The production of one or even both toxins is not always sufficient for producing symptoms.
Zinc supplementation is recommended in children. [2] Antibiotics are generally not needed. [14] However, antibiotics are recommended for young children with a fever and bloody diarrhea. [1] In 2015, there were two billion cases of gastroenteritis, resulting in 1.3 million deaths globally.