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Drug Notebook

FDA Alerts

    Diarrhea and Colitis
  • Clostridium difficile-associated diarrhea and colitis (CDAD; also known as antibiotic-associated diarrhea and colitis or pseudomembranous colitis) has been reported with nearly all anti-infectives, including clindamycin, and may range in severity from mild to life-threatening. Anti-infectives alter normal flora of the colon and may permit overgrowth of clostridia; a toxin produced by C. difficile is one primary cause of antibiotic-associated colitis.
  • It is important to consider a diagnosis of CDAD in patients who develop diarrhea subsequent to clindamycin treatment. Diarrhea, colitis, and pseudomembranous colitis have been observed to begin up to several weeks after cessation of clindamycin therapy.
  • After a diagnosis of CDAD has been established, initiate therapeutic measures.

    Mild cases usually respond to drug discontinuation alone.

    In moderate to severe cases, consideration should be given to management with fluids and electrolytes, protein supplementation, and treatment with an anti-infective clinically effective against CDAD. (See Superinfection/Clostridium difficile-associated Diarrhea and Colitis under Cautions.)

  • Because clindamycin has been associated with severe colitis (potentially fatal), it should be reserved for treatment of serious infections when less toxic anti-infectives are inappropriate.
  • Do not use for nonbacterial infections.

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clindamycin
(KLIN da MYE sin)
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