Pseudomembranous colitis risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
In most cases a patient presenting with pseudomembranous colitis has recently been on antibiotics. Antibiotics disturb the normal bowel bacterial flora. Clindamycin is the antibiotic classically associated with this disorder, but any antibiotic can cause the condition. Even though they are not particularly likely to cause pseudomembranous colitis, but, rather, due to their very frequent use, cephalosporin antibiotics (such as cefazolin and cephalexin) account for a large percentage of cases. Diabetics and the elderly are also at increased risk, although half of cases are not associated with risk factors.
Risk Factors
- Clindamycin
- Increasing age
- Recent major surgery
- Proton-pump inhibitors: There is some evidence that proton pump inhibitors are a risk factor for pseudomembranous colitis,[1] but others question whether this is a false association or statistical artifact (increased PPI use is itself a marker of increased age and co-morbid illness).[2] Indeed, one large case-controlled study showed that PPI's are not a risk factor.[3]
- Ciprofloxacin: Recently, evidence has emerged to suggest that the use of ciprofloxacin (in addition to a primary causative antibiotic such as clindamycin) is associated with increased mortality in patients with pseudomembranous colitis.
References
- ↑ Dial S, Delaney C, Schneider V, Suissa S. (2006). "Proton pump inhibitor use and risk of community-acquired Clostridium difficile-associated disease defined by prescription for oral vancomycin therapy". CMAJ. 175 (7): 745&ndash, 48. doi:10.1503/cmaj.060284.
- ↑ Pépin J, Saheb N, Coulombe M; et al. (2005). "Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile associated diarrhea: a cohort study during an epidemic in Quebec". Clin Infect Dis. 41: 1254&ndash, 60. doi:10.1086/496986. PMID 16206099.
- ↑ Lowe DO, Mamdani MM, Kopp A, Low DE, Juurlink DN (2006). "Proton pump inhibitors and hospitalization for Clostridium difficile-associated disease: a population-based study". Clin Infect Dis. 43 (10): 1272&ndash, 6. PMID 17051491.