COLITIS ASSOCIATED WITH ORAL CLINDAMYCIN THERAPY - CLINICAL-STUDY OF 16 PATIENTS

The clinical, radiologic and histologic features of 16 patients hospitalized with clindamycin-associated colitis are presented. The findings are tabulated and compared to 33 cases reported in the literature. The majority of patients were Caucasian females over 40 yr of age. The clinical presentation varied from mild persistent diarrhea to acute surgical abdomen. Proctoscopic examination revealed nonspecific colitis in 9 and pseudomembranous colitis in 7 cases. No specific radiologic or histologic findings for postantibiotic colitis were found. Therapy was nonspecific and varied according to the severity of the clinical course. Clinically, there appeared to be some benefit from systemic steroid therapy. Four of the 16 patients died. None of the recovered patients had spontaneous relapses off medication during follow-up evaluation. The pathogenic mechanism for post-antibiotic colitis secondary to clindamycin remains unknown and does not appear dose related. Clindamycin therapy should be limited to disorders with specific indications.