C. Difficile - Antibiotics that cause it

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Did antibiotics cause your C. difficile colitis? Which one(s) did you take?

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Which antibiotics cause C. difficile colitis?

Although the antibiotic clindamycin (Cleocin) has been widely recognized as causing C. difficile colitis, many commonly prescribed antibiotics also cause colitis. Examples of antibiotics that frequently cause C. difficile colitis include:

  • ampicillin,
  • amoxicillin, and
  • cephalosporins [such as cephalexin (Keflex)].

Antibiotics that occasionally cause C. difficile colitis include:

  • penicillin,
  • erythromycin,
  • trimethoprim, and
  • quinolones such as ciprofloxacin (Cipro).

Antibiotics that rarely if ever cause C. difficile colitis include:

  • tetracycline,
  • metronidazole (Flagyl),
  • vancomycin (Vancocin), and
  • aminoglycosides [such as gentamicin (Garamycin)].

In fact, metronidazole and vancomycin are two antibiotics that are used for treating C. difficile colitis; however, there are rare reports of C. difficile colitis occurring several days after stopping metronidazole.

While most C. difficile colitis in the US is caused by antibiotics, C. difficile colitis also can occur in patients without exposure to antibiotics. For example, patients with ulcerative colitis and Crohn's disease have been known to develop C. difficile colitis without exposure to antibiotics.

Since many antibiotics can cause C. difficile infection, all antibiotics should be used prudently. Self-administration or using antibiotics without an accurate diagnosis or a proper reason should be discouraged. On the other hand, benefits of properly prescribed antibiotics for the right reasons usually far outweigh the risk of developing C. difficile colitis.

Antibiotics can sometimes cause diarrhea that is not due to C. difficile infection. The reason for the diarrhea is not clear. The practical implication is that not all diarrhea associated with antibiotics should be considered to be due to C. difficile and treated as such.

Return to Clostridium Difficile Colitis (Antibiotic-Associated Colitis, C. difficile colitis)

See what others are saying

Comment from: Mary8479, 25-34 Female (Patient) Published: October 22

I had been on Septra, Cipro, Macrobid, etc., for chronic urinary tract infections. My urologist put me on Keflex for 3 months. Six days later I get C. difficile colitis.

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Comment from: JustJane, 55-64 Female (Patient) Published: November 03

I was on levofloxacin, for a severe sinus infection. I had two 10 day protocols before a surgery to implant a pain pump. The day I entered the hospital for surgery I realized, when I was weighed, I had lost 9 lb. in the 10 days before surgery. I had surgery on a Thursday and on Saturday I started having diarrhea. I was given Keflex for 5 days following surgery by my surgeon and was only diagnosed with C. difficile colitis 2 weeks later. My primary care physician put me on Flagyl for 10 days and there is no change. He gave me an additional 5 days and still no change.

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