J P Teare1, J C Booth, J L Brown, J Martin, H C Thomas. 1. Department of Medicine, St Mary's Hospital Medical School, Imperial College of Science Technology and Medicine, London, UK.
Abstract
OBJECTIVE: To describe the association of clarithromycin, used to treat Helicobacter pylori infection and duodenal ulceration, with pseudomembranous colitis in two patients. SETTING: St Mary's Hospital, London, UK. PATIENTS: Two female patients aged 77 and 78 years, admitted with duodenal ulceration and H. pylori infection. INTERVENTION: Clarithromycin (500 mg three times daily) was administered concurrently with omeprazole (40 mg once daily). OUTCOME MEASURES: After an initial improvement in symptoms both patients experienced persistent Clostridium difficile-associated diarrhoea. CONCLUSIONS: High-dose clarithromycin should be used with caution for the treatment of H. pylori infection associated with gastroduodenal ulceration. The drug may induce antibiotic-associated colitis which can lead to morbidity and mortality, particularly in the elderly.
OBJECTIVE: To describe the association of clarithromycin, used to treat Helicobacter pyloriinfection and duodenal ulceration, with pseudomembranous colitis in two patients. SETTING: St Mary's Hospital, London, UK. PATIENTS: Two female patients aged 77 and 78 years, admitted with duodenal ulceration and H. pyloriinfection. INTERVENTION: Clarithromycin (500 mg three times daily) was administered concurrently with omeprazole (40 mg once daily). OUTCOME MEASURES: After an initial improvement in symptoms both patients experienced persistent Clostridium difficile-associated diarrhoea. CONCLUSIONS: High-dose clarithromycin should be used with caution for the treatment of H. pyloriinfection associated with gastroduodenal ulceration. The drug may induce antibiotic-associated colitis which can lead to morbidity and mortality, particularly in the elderly.
Authors: Anca Trifan; Irina Girleanu; Camelia Cojocariu; Catalin Sfarti; Ana Maria Singeap; Carmen Dorobat; Lucia Grigore; Carol Stanciu Journal: World J Gastroenterol Date: 2013-11-14 Impact factor: 5.742