Antibiotic-associated diarrhoea

In most cases of antibiotic-associated diarrhoea, a pathogen is not identified. Clostridioides difficile (formerly known as Clostridium difficile) is the pathogen in a significant minority of cases.

The mainstay of management of antibiotic-associated diarrhoea is stopping the likely causative antibiotics, if possible, and rehydration.

Although prophylactic probiotics are widely used to prevent antibiotic-associated diarrhoea, several large randomised controlled trials have not demonstrated a benefit, and probiotics have been shown to delay gut microbiome reconstitution following antibiotic therapyAllen, 2013Kolodziej, 2019Rajkumar, 2020Suez, 2018. In patients with immune compromise, cases of probiotic-associated bacteraemia have occurred.