PROSPECTIVE-STUDY OF TOXIGENIC CLOSTRIDIUM-DIFFICILE IN CHILDREN GIVEN AMOXICILLIN CLAVULANATE FOR OTITIS-MEDIA/

Objective. Evaluate antibiotic associated diarrhea and toxigenic Clost ridium difficile in stool specimens obtained from children before and after 10 days of amoxicillin/clavulanate for otitis media. Design. Chi ldren, 12 to 47 months of age, treated with amoxicillin/clavulanate fo r otitis media in an outpatient setting were enrolled. Stool specimens were obtained at enrollment, when diarrhea occurred and at the end of therapy. All stool specimens were tested for C. difficile toxins A an d B by enzyme immunoassay. Results. Seventy six children who had stool specimens collected at enrollment and after therapy were included in the analysis, None had C. difficile toxin in stool specimens at enroll ment. Six (27%) of 22 children with diarrhea, and 4 (7%) of 54 childre n without diarrhea had C. difficile toxin present at completion of the rapy (P = 0.03). Conclusion. Toxigenic C. difficile was identified in 13% of children at the conclusion of amoxicillin/clavulanate therapy w ith a significantly higher frequency in children with diarrhea.