What is antibiotic-associated diarrhea?
Antibiotic-associated diarrhea is a side effect of taking
antibiotic medicine. Symptoms usually start between 4 and 9
days after you start to take the medicine. Most often the
loose bowel movements are mild and go away when you stop
taking the antibiotic. Sometimes a very serious type of
diarrhea called pseudomembranous colitis happens.
How does it occur?
Antibiotics can upset the natural balance of
bacteria in the intestines. Each antibiotic medicine is
usually given because of specific bacteria. When an
antibiotic kills one type of bacteria, other bacteria in the
gut are present in greater numbers. Too many harmful
bacteria in the intestines can cause diarrhea. Having too
many of the bacteria called Clostridium difficile causes
severe diarrhea (pseudomembranous colitis).
Almost any antibiotic can cause an imbalance of bacteria in
the body.
What are the symptoms?
The main symptom of mild antibiotic-associated diarrhea is
loose bowel movements or more bowel movements than normal.
Symptoms of pseudomembranous colitis are more severe and may
include:
- a lot of watery diarrhea (sometimes bloody)
- abdominal pain and cramping
- nausea
- dehydration
- fever.
How is it diagnosed?
Your health care provider will ask about the medicines you
are taking. If your symptoms are mild, you may not need any
lab tests.
If you have more severe symptoms, your provider may check a
sample of bowel movement. Your provider may examine the
lining of your rectum and lower bowel.
How is it treated?
If your symptoms are mild, your health care provider may
recommend that you:
- Stop taking the antibiotic.
- Change your diet for a few days.
If your symptoms are more severe, you may need bed rest,
intravenous (IV) fluids, and another antibiotic to treat
bacteria causing the severe symptoms.
How long do the effects last?
In mild cases, diarrhea may last up to 14 days after you
stop taking the antibiotic. In more severe cases, the
symptoms may not go away until several weeks after you begin
treatment, and the symptoms may return after treatment.
This is because some antibiotics have an effect on the
bacteria for a long time.
How can I take care of myself?
Follow your health care provider's instructions for rest,
activity, medicine, and diet. Your provider will probably
suggest that you:
- Drink clear liquids, such as water, apple juice, tea,
bouillon, and flat ginger ale.
- Eat only bland foods in small amounts, such as soda
crackers, toast, plain pasta, noodles, bananas, and baked
or broiled potatoes.
- Avoid foods and drinks that sometimes cause diarrhea.
These foods include caffeine, alcohol, milk and milk
products, large amounts of fruit or fruit juices (except
bananas), and foods seasoned with hot peppers.
- After a few days, you may return to normal eating,
carefully adding back any of the foods that sometimes
cause diarrhea.
If you have cramps or abdominal pain, it may help to put a
hot water bottle or electric heating pad at the lowest
setting on your abdomen.
If your health care provider prescribes a new antibiotic,
take all of the medicine as prescribed.
Call your health care provider if:
- Your pain does not go away or gets worse.
- Your diarrhea or other symptoms get worse.
What can I do to help prevent antibiotic-associated
diarrhea?
- Take antibiotics only when you and your health care
provider feel they are necessary.
- Take antibiotics exactly as they are prescribed. Do not
increase the dose, the time between your doses, or the
number of days you take the medicine unless instructed
to do so by your health care provider.
- When possible, avoid taking antibiotics that cause you to
have these symptoms.


Disclaimer: This content is reviewed periodically and is subject to
change as new health information becomes available. The
information provided is intended to be informative and educational and is not a
replacement for professional medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
HIA File DIG4041F.HTM Release 9.0/2006. Copyright © 2006 McKesson Corporation and/or one of its subdiaries. All Rights Reserved.
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