Antibiotic-associated pseudomembranous colitis in children.

Abstract

Ten cases of antibiotic-associated pseudomembranous colitis in children are reviewed. The ages ranged from 4 years to 17 years; the most frequently implicated antimicrobial agents were penicillins in six children and clindamycin in two. Stool assays showed specimens from all ten patients yielded a cytopathic toxin which was neutralized by Clostridium sordellii antitoxin with titers ranging from 1:40 to 1:40,000. Bacterial cultures of nine specimens uniformly yielded Clostridium difficile with a median concentration of 10(5.4) organisms per gram of wet weight. All nine isolates of C difficile showed a vitro production of a cytopathic toxin which was similar to or identical with that which was detected in the original stool specimen. All ten patients recovered. Six were treated with oral vancomycin and showed a good therapeutic response; one patient, however, suffered two relapses when treatment was discontinued, requiring a total of three courses of oral vancomycin. Two patients received cholestyramine and responded well. These observations provide supportive evidence that C difficile is responsible for antibiotic-associated pseudomembranous colitis in children and document efficacy of the newer therapeutic modalities in this patient population as well.

• Authors: R P Viscidi, J G Bartlett
• Journal: Pediatrics (Pediatrics) Vol. 67 Issue 3 Pg. 381-6 (Mar 1981) ISSN: 0031-4005 [Print] United States
• PMID: 7243476 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Cholestyramine Resin
• Clindamycin
• Vancomycin
• Ampicillin
• Penicillin G

Topics

• Administration, Oral
• Adolescent
• Ampicillin (adverse effects)
• Anti-Bacterial Agents (adverse effects)
• Child
• Child, Preschool
• Cholestyramine Resin (therapeutic use)
• Clindamycin (adverse effects)
• Clostridium (isolation & purification)
• Clostridium Infections (complications)
• Enterocolitis, Pseudomembranous (chemically induced, drug therapy, etiology)
• Feces (analysis)
• Female
• Humans
• Infant
• Male
• Penicillin G (adverse effects)
• Vancomycin (therapeutic use)