ISSN 2398-2985      

Toxicity: antibiotic

6guinea pig

Synonym(s): Antibiotic toxicity, Antibiotic-associated toxicity


Introduction

  • Cause: administration of an antibiotic that targets Gram-positive bacteria, thereby destroying the normal flora and permitting overgrowth of Gram-negative organisms and primarily, anaerobic organisms such as Clostridium difficile. Administration of an antibiotic that is directly toxic.
  • Signs: acute diarrhea, collapse, death.
  • Diagnosis: history of being given an antibiotic such as ampicillin, amoxicillin, lincomycin, clindamycin, erythromycin, bacitracin, streptomycin, cephalosporins
  • Treatment: generally unrewarding but if caught quickly, oral and rectal metronidazole, fluid therapy, antibiotic that will be active against Gram-negative organisms.
  • Prognosis: poor.
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Pathogenesis

Etiology

  • History: was administered an inappropriate antibiotic, ie ampicillin, amoxicillin, lincomycin, clindamycin, erythromycin, bacitracin, streptomycin Streptomycin, cephalosporins.

Predisposing factors

General

  • Whatever condition led to being given an antibiotic.

Specific

  • Illness that precipitated the need for an antibiotic.

Pathophysiology

  • Normal intestinal flora is predominantly Gram-positive organisms like streptococci and lactobacilli.
  • Administration of antibiotics that hit predominantly Gram-positive organisms result in overgrowth of Gram-negative bacteria and in particular the anaerobe Clostridium difficile.
  • Those antibiotics may have been administered orally, parenterally or topically and caused the toxicity.
  • Clostridium difficile is the main organism causing the enterotoxemia.
  • E. coli has been linked to a bacteremia.
  • Streptomycin Streptomycin is directly ototoxic by causing degeneration of vestibular hair cells. This may also be caused by higher than recommended doses of chlorampenicol Chloramphenicol and aminoglycosides.

Timecourse

  • Usually rapid - within a few days of the antibiotic administration.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • Hrapkiewicz K & Medina L (2007) Clinical Laboratory Animal Medicine an Introduction. 3rd edn. Blackwell Publishing. pp 126.

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