Nearly all antibiotics can cause pseudomembranous colitis in a small minority of people. Its severity can range from mild to life-threatening. Only the following antibiotic families and clindamycin, however, are implicated in the recent outbreaks of the most virulent Clostridium difficile-associated infections.
In their editorial for The New England Journal of Medicine, John G. Barlett, MD, and Trish M. Perl MD, advised doctors to use restraint in the use of second- and third-generation cephalosporins, fluoroquinolones, or a combination of the three:
Fluoroquinolone Antibiotic Family
The family includes Ciprofloxacin, Gatifloxacin, Levofloxacin, Lomefloxacin, Norfloxacin, Ofloxacin, Sparfloxacin, and Trovafloxacin. Each is known by one or more brand names. Ciprofloxacin, for example, is sold under four brand names: Ciloxan, Cipro, Cipro Cystitis Pack, and Cipro HC. The first drug in this family was introduced in 1984.
Cephalosporins Antibiotic Family
Each drug in this family can have one to three different brand names. Some brand names for second- and thirdgeneration cephalosporins include: Vantin, Zinacef, Ceclor, Suprax, Lorabid, Ceftin, and Cefzil. The first drug in this family was introduced in 1974.
Clindamycin
Introduced in 1973, clindamycin has been reserved for life-threatening infections that do not respond to penicillin or other antibiotics. It is sold under the brand names of Cleocin, Cleocin Pediatric, Cleocin T, Cleocin Vaginal Cream, Dalacin C, and Dalacin T.
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