Recent studies have shown considerable progress in the diagnosis, etiology, and therapy of antibiotic-associated pseudomembranous colitis. Previous work has implicated a number of antimicrobial agents, but there are relatively few reports concerning the role of cephalosporins. The subject of the present report is 17 patients with pseudomembranous colitis associated with cephalosporin use. Tissue cultures of stools from all patients showed a cytotoxin that is neutralized by C sordellii antitoxin. Bacterial cultures of these specimens yielded strains of C difficile that produced a similar cytotoxin in vitro. Nine of the patients were treated orally with vancomycin hydrochloride and all responded. This experience illustrates the importance of considering the diagnosis of pseudomembranous colitis in patients in whom diarrhea develops in association with cephalosporin use.
(JAMA 242:2683-2685, 1979)
Bartlett JG, Willey SH, Chang TW, Lowe B. Cephalosporin-Associated Pseudomembranous Colitis due to Clostridium difficile. JAMA. 1979;242(24):2683–2685. doi:10.1001/jama.1979.03300240023018