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What Causes Diarrhea, Stomach Cramps And Frequent Bowel Movement After Taking Azithromycin?

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Posted on Wed, 13 Jan 2016
Question: I have taken azithromycin about 30 days ago. prescribed by my V.A. doctor due to sinus infection
I have had a very lose stool several times since. The last 4 days it has been really bad, stomach
cramps an black and brown liquid with foul smell. Some vomiting yesterday. Can you help me?
Thank you,
XXXX
doctor
Answered by Dr. Panagiotis Zografakis (44 minutes later)
Brief Answer:
it could be antibiotic associated diarrhea

Detailed Answer:
Hello,

although prolonged diarrhea requires investigation to identify the cause, I can say that the most likely cause in your case is antibiotic-associated diarrhea. Azithromycin is one of the commonest offenders related to this syndrome. It can cause prolonged diarrhea - sometimes bloody - and perhaps also fever and serious colitis. Clostridium difficile is a commonly implicated pathogen which causes pseudomembranous colitis.

In any case of prolonged diarrhea particularly after having used antibiotics the following testing should be done:
- microscopic examination of the stool
- stool culture
- stool examination for ova and parasites
- Clostridium difficile toxin in the stool

Depending on the patient's condition colonoscopy might be required, which would also be diagnostic for pseudomembranous colitis.

If no cause can be identified with the aforementioned investigation, then more tests would have to be done (like HIV-testing, malabsorption tests, etc).

If pseudomembranous colitis is the final diagnosis then metronidazole or vancomycin can be used depending on the patient's status. For the more serious cases vancomycin outbalances metronidazole in terms of efficacy.

I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.

Kind Regards!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3809 Questions

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What Causes Diarrhea, Stomach Cramps And Frequent Bowel Movement After Taking Azithromycin?

Brief Answer: it could be antibiotic associated diarrhea Detailed Answer: Hello, although prolonged diarrhea requires investigation to identify the cause, I can say that the most likely cause in your case is antibiotic-associated diarrhea. Azithromycin is one of the commonest offenders related to this syndrome. It can cause prolonged diarrhea - sometimes bloody - and perhaps also fever and serious colitis. Clostridium difficile is a commonly implicated pathogen which causes pseudomembranous colitis. In any case of prolonged diarrhea particularly after having used antibiotics the following testing should be done: - microscopic examination of the stool - stool culture - stool examination for ova and parasites - Clostridium difficile toxin in the stool Depending on the patient's condition colonoscopy might be required, which would also be diagnostic for pseudomembranous colitis. If no cause can be identified with the aforementioned investigation, then more tests would have to be done (like HIV-testing, malabsorption tests, etc). If pseudomembranous colitis is the final diagnosis then metronidazole or vancomycin can be used depending on the patient's status. For the more serious cases vancomycin outbalances metronidazole in terms of efficacy. I hope you find my comments helpful! You can contact me again, if you'd like any clarification or further information. Kind Regards!