Which patients are at increased risk for developing antibiotic-associated diarrhea?

Patients with a history of Clostridium difficile infection are at increased risk for developing antibiotic-associated diarrhea. This is primarily due to the fact that previous infections can disrupt the normal gut flora, making it more susceptible to further disturbances caused by antibiotics. When antibiotics are used, they can eliminate a significant portion of the beneficial bacteria in the gut, allowing C. difficile, which is often resistant to antibiotics, to proliferate and produce toxins that lead to diarrhea and colitis.

Individuals with a prior C. difficile infection not only have experienced the consequences of dysbiosis previously but may also harbor spores of the bacteria. Therefore, when these patients are treated with antibiotics, the likelihood of recurrence or exacerbation of an infection due to C. difficile increases. This understanding highlights the importance of careful selection and monitoring of antibiotic therapy in patients with this history to prevent complications such as antibiotic-associated diarrhea.