ABSTRACT

Pseudomembranous enterocolitis (PME) is the consequence of a filterable, heat-labile enterotoxin elaborated by selected strains of Clostridium difficile. In selected cases, the antibiotic in question eradicates that portion of the gastrointestinal tract flora that suppresses the growth of C. difficile. The loss of bacterial interference permits the resistant C. difficle to numerically partially fill the biologic void created, and in so doing elaborate the exotoxins. A single dose of an antibiotic given for cesarean section prophylaxis is capable of inducing disease. Privitera et al. studied C. difficile intestinal colonization following a single two gram intravenous dose of either a cephalosporin or mezlocillin. C. difficile was detected in 23% of patients who had received a cephalosporin, in 3.3% of patients given mezlocillin and in none of the 15 controls given no antibiotics.