ANTIBIOTIC-ASSSOCIATED HEMORRHAGIC COLITIS

Antibiotic-associated hemorrhagic colitis is an infrequently recognize d, self-limited process that may be experienced by patients receiving oral penicillin derivatives, primarily for upper respiratory infection s. Symptoms of diarrhea, abdominal tenderness, and ultimately bloody d iarrhea occur within one week of antibiotic use. Resolution of symptom s typically occurs within three days of discontinuing the offending an tibiotic. Previous reports have suggested a non-inflammatory process i nvolving the right colon. We present four cases and review the literat ure with respect to presentation, diagnosis, course, and postulated pa thophysiologic mechanisms. Our patients demonstrate a more heterogeneo us population than previously noted. This disease can affect young and old, male and female, and can involve the entire colon. Active inflam mation demonstrated by fecal leukocytes, peripheral leukocytosis, and an active inflammatory infiltrate on biopsy are reported.