Indian J Pediatr 1993; 60 : 591-594 Antibiotic Associated Colitis S.H. Ahmad, P. Kumar, S. Fakhir, K.N. Ahmad*, Ashok Rattan**, R.S. Channa*** and Geeta Bajaj Departments of Pediatrics, *Pathology, **Microbiologyand ***PediatricSurgery, J.N. Medical College, Aligarh Muslim University, Aligarh Abstract. It is a prospective study based on 100 consecutive cases of diarrhea following antibiotic therapy admitted to the pediatric services of J.N. Medical College, A.M.U., Aligarh between Janu- ary to December 1987. They had C. penicillin (50), chloramphenicol (34), ampicillin (34), gentami- cin (34), cephalosporin (4) and cotrimoxazole (4) for 3 days to 3 weeks prior to the onset of diar- rhea. Apart from routine and special investigations, naked eye and microscopic examination of stool, its culture for pathogens including CI. difficile were carried out in all cases. Presence of CL difficile cytotoxin was demonstrated by observing the cytopathic. Effect on veru cell culture, 18 grew CL difficile (14 cyto toxin positive). Frequency of fever, vomiting, abdominal distension, dehy- dration and duration of diarrhea was not different (p 9 0.05) in the two groups. Purge rate and presence of mucus and blood in CI. difficile positive patients was significantly higher (p < 0.05). Eight CI. difficile positive (7 cytotoxin + ve) were subjected to endoscopy. Three of them showed P.M. colitis and 2 non specific colitis. Chloromycetin, gentamicin and penicillin were the main cul- prits responsible for AAC. None of the patients given ampicillin alone suffered from AAC. The mortality was 5%. (Indian J Pedlatr 1993; 60 : 591o594) Key words : Diarrhea; Antibiotic associated diarrhea (AAD); Antibiotic associated colitis (AAC). Diarrhea following use of antibiotics is a frequent occurrence while the more severe, life threatening complication of pseudo- membranous colitis has been only recently recognised. The exact etiology remained elusive till 19771 when toxin producing clostridia were implicated. Only 22.3 re- ports are from India in the pediatric age group since then. The present work was undertaken to determine the prevalence, clinical profile and prognosis of AAC in hospitalised children. Further, it was also aimed to find out the incidence of AAC in Reprint requests : Dr. S.H. Ahmad, Professor & Chairman, Department of Pediatrics, J.N. Medical College, Aligarh Muslim University, Aligarh-202 002. relation to various antibiotic in use in this country. MATERIAL AND METHODS One hundred consecutive children below 12 years of age who developed diarrhea (passage of more than 3 liquid stools/day) following antibiotic therapy given between January to December 1987 were included. An informal parental consent was obtained before inclusion into the study. A detail history was taken and physical examina- tion carried out in all these children. Inves- tigations included hemogram, peripheral smear urinalysis, physical, chemical, microscopic and culture examination of stool.