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Patients with diarrhea as a side effect of antibiotics typically have watery diarrhea during a course of antibiotics. Upper abdominal symptoms of nausea and vomiting are rare and systemic symptoms should be absent.


  1. Diarrhea complicates up to 25% of antibiotic courses.

  2. Although any antibiotic can be associated with diarrhea, those most commonly responsible for diarrhea are:

    1. Clindamycin

    2. Cephalosporins

    3. Ampicillin, amoxicillin, and amoxicillin-clavulanate

  3. Patients with diarrhea caused by side effects of antibiotics usually have mild disease that occurs either during or immediately after a course of antibiotics. Possible causes of this type of diarrhea are numerous:

    1. Change in intestinal flora

    2. Nonantimicrobial effect of antibiotics such as the promotility effects of erythromycin.


  1. Diarrhea due to antibiotic use is more likely when certain features are present:

    1. History of previous diarrhea associated with antibiotics

    2. Mild to moderate symptoms

  2. Symptoms almost always resolve shortly after discontinuation of antibiotics.


  1. Diarrhea as a side effect of antibiotic use usually resolves with discontinuation of antibiotics.

  2. Probiotic agents may reduce the risk of antibiotic-associated diarrhea and may shorten an episode once it has occurred.

  3. Antidiarrheal agents such as loperamide can provide symptomatic relief.

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