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Antibiotic-associated diarrhea common in patients prescribed carbapenems

Issue: October 2011

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CHICAGO — Although it is known that antibiotic-associated diarrhea is common among patients prescribed antibiotics, 7% of patients prescribed certain classes of carbapenems, including ertapenem and meropenem, experienced antibiotic-associated diarrhea in the hospital setting.

Dhara N. Shah, PharmD, of the University of Houston College of Pharmacy, presented these findings during a poster session at the 2011 Interscience Conference on Antimicrobial Agents and Chemotherapy.

For the prospective cohort study, Shah and colleaguesassessed the incidence for antibiotic-associated diarrhea (AAD) among 308 hospitalized patients prescribed piperacillin-tazobactam, ceftriaxone, cefepime, meropenem (Merrem, AstraZeneca), levofloxacin or vancomycin between 2008 and 2010.

After patients received antibiotics, the researchers followed patients daily and assessed for new onset of diarrhea. The researchers defined AAD as “three or more unformed stools per day for at least 2 consecutive days while on antibiotic therapy and for up to 7 days after discontinuation of therapy.”

Overall, 35% of patients experienced diarrhea, of which 20% were diagnosed with AAD; no patients tested positive for C. difficile.

Of the 7.1% of patients that experienced AAD while receiving antibiotics, AAD was most commonly associated with ertapenem and meropenem (11% for both), cefepime and piperacillin (10% for both), vancomycin (9%) and levofloxacin and ceftriaxone (2% for both).

For more information:

• Shah DN. #K-192. Presented at: The 2011 ICAAC; Sept. 17-20; Chicago.

George A. Pankey, MD

This study emphasizes the frequency (7%) of hospitalized patient non-Clostridium difficile antibiotic associated diarrhea (AAD). As would be expected, the broadest spectrum agents (carbapenems, cefepime and pipercillin/taxobactam) were most often correlated with AAD. It would be interesting to know how the AAD patients were treated. Surprisingly, no AAD patient was positive for C. difficile.

– George A. Pankey, MD

Infectious Disease News Editorial Board member

Disclosure: Dr. Pankey reports no relevant financial disclosures.

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