抗生素相关性腹泻治疗及预防

Treatment and prevention of antibiotic associated diarrhea

1引言抗生素相关性腹泻（antibiotic associated diarrhea,AAD）是指伴随抗生素使用而发生的无法用其他原因解释的腹泻〔1〕。对应用抗生素种类不同,成人AAD发病率达5%～25%〔2〕。随着广谱抗生素应用增加,自1950年人们开始关注这类腹泻。AAD严重程度从单纯性腹泻到难辨梭状芽孢杆菌（C.difficile）相关性腹泻以及假膜性结肠炎（PMC）。

Summary Mild or severe episodes of antibiotic-associated diarrhea(A AD) are common side effects of antibiot-ic therapy.The advent of broad spectrum antibiotic therapy has led to an increase in antibiotic associated diarrhea.For nearly two thirds of the AAD cases,the etiology is not known.But Clostridium difficile accounts for nearly one third of all cases.In most cases of AAD,discontinuation or replacement of the inciting antibiotic by another drug with lower AAD risk can be effective.For more severe cases involving C.difficile,the treatment of diarrhea requires an antibiotic treatment with glycopeptides(vancomycin) or metronidazole.One potential strategy to prevent AAD is the concurrent use of probiotic bacteria or yeast.