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Antibiotic-Associated Diarrhea
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Antibiotic-associated diarrhea - (AAD)

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If you have mild diarrhea, your symptoms are likely to clear up within a few days to two weeks after your antibiotic treatment ends. In the meantime, your doctor may recommend drinking plenty of liquids to prevent dehydration and avoiding foods that may aggravate your symptoms. When diarrhea is more severe, your doctor may stop your antibiotic therapy and wait for your symptoms to subside.

In cases of very severe diarrhea, colitis or pseudomembranous colitis, you're likely to be treated with the drug metronidazole (Flagyl), which is usually taken in tablet form for 10 days. If metronidazole isn't effective, or you're pregnant or breastfeeding, you'll receive another drug, vancomycin (Vancocin).

Both metronidazole and vancomycin are antibiotics that effectively control C. difficile. Vancomycin was once the drug of choice for treating AAD, but it's now usually reserved for the most resistant cases. It's also recommended for pregnant and lactating women because the effects of metronidazole on fetuses and infants aren't known.

Some people treated for pseudomembranous colitis have a recurrence of symptoms and need further treatment.

The term probiotic means "for life." It generally refers to concentrated supplements of beneficial bacteria similar to those that occur naturally in your intestinal tract. Most probiotic supplements are formulated to survive the digestive process and the highly acidic conditions in your stomach.

Giving probiotic supplements to children receiving antibiotics can help prevent AAD. But the results of studies on adults have been mixed. Some studies have shown probiotic supplements to be effective in preventing or reducing the symptoms of AAD, while others have not. Anecdotal evidence indicates that instilling probiotics rectally may be more beneficial than taking them orally.

Probiotic formulas are available in liquid and capsule form in drugstores and natural food stores and in some grocery stores. Many need refrigeration. In addition, commercial yogurt labeled as having live cultures contains certain "good" bacteria, such as Lactobacillus acidophilus.

Another probiotic, the yeast Saccharomyces boulardii, has been shown to help protect against pseudomembranous colitis. This yeast, taken orally, is used in Europe to help prevent symptoms of AAD and may also prevent recurrences of the disease.

Capsules of S. boulardii are available in natural food stores and some drugstores. Although S. boulardii rarely causes side effects, avoid it if you have a yeast allergy. And if you have HIV/AIDS, talk to your doctor before trying this product.


The following suggestions may help prevent AAD or reduce its severity:

  • Take antibiotics only when you and your doctor feel it's absolutely necessary. Keep in mind that antibiotics won't help viral infections such as colds and flu.

  • Use antibiotics exactly as prescribed. Don't increase the dose, double up on missed doses, or take the medication longer than your doctor recommends.

  • Consider eating yogurt or taking probiotic capsules before, during and after antibiotic treatment.


If you develop AAD, colitis or pseudomembranous colitis, these dietary changes may help ease your symptoms:

  • Drink plenty of fluids. Water is best, but fluids with added sodium and potassium (electrolytes) may be beneficial as well. Avoid carbonated beverages, citrus juices, alcohol and caffeinated drinks such as coffee, tea and colas, which may aggravate your symptoms.

  • Emphasize soft, bland, easy-to-digest foods. These include rice, plain baked potatoes, yogurt and bananas. It's best to avoid most other fruits and their juices as well as dairy foods because they can make diarrhea worse.

  • Try eating several small meals. Space meals throughout the day instead of eating two or three large ones. Smaller servings are easier to digest.

  • Avoid certain foods. Stay away from spicy, fatty or fried foods and any other foods that make your symptoms worse.

Also, check with your doctor first before taking antidiarrheal medications, which may interfere with your body's ability to eliminate toxins and lead to serious complications.



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