Old problems and new perspectives of antibiotic-associated diarrhea in children

Antibiotics are commonly used in Pediatric Intensive Care Unit.Diarrhea is clearly one of the most common side effects encountered with antibiotic therapy.Most cases of antibiotic-associated diarrhea can be classified in two categories:cases in which Clostridium difficile is implicated and cases in which no putative agent or recognized pathophysiological mechanism is clearly established.In most cases of antibiotic-associated diarrhea in which Clostridium difficile is not detected,no etiologic agent is identified,and diarrhea is usually mild and self-resolving.As the cause of approximately 25％ of all cases of antibiotic-associated diarrhea,Clostridium difficile is responsible for almost all cases of pseudomembranous colitis and many instances of severe antibioticassociated diarrhea.For that reason,the term antibiotic-associated diarrhea is often considered synonymous with Clostridium difficile-associated diarrhea.Through a comprehensive review of current medical literature,this article provides an update on pathogenesis,diagnostics as well as therapeutic and prevention strategies,which may be helpful in clinical prctice. Key words: Antibiotic associated diarrhea;  Clostridium difficile;  Children