Clostridium difficile Colitis

Abstract

THE ASSOCIATION between antibiotic use and pseudomembranous colitis was suggested as early as 1952 by Reiner and colleagues,¹ and widely accepted by 1974 when Tedesco and others² prospectively studied the colonic sequelae of clindamycin use. Bartlett and associates³ subsequently identified Clostridium difficile as the offending pathogen. These investigators were further able to demonstrate that a bacterial toxin rather than a viral or direct bacterial process mediated antibiotic-associated colitis. Since then, accumulated evidence has established antibiotic use as the primary risk factor for pseudomembranous colitis and opportunistic C difficile infection as the cause of antibiotic-associated colitis, regardless of pseudomembrane formation.^4-6