Search tips
Search criteria 


Logo of aacPermissionsJournals.ASM.orgJournalAAC ArticleJournal InfoAuthorsReviewers
Antimicrob Agents Chemother. 1991 January; 35(1): 208–210.
PMCID: PMC244972

Prospective study of Clostridium difficile intestinal colonization and disease following single-dose antibiotic prophylaxis in surgery.


A total of 108 volunteers undergoing an elective surgical procedure were randomly given a single 2-g intravenous prophylactic dose of either a cephalosporin or mezlocillin. Stool samples were cultured for Clostridium difficile the day before the operation and later on postoperative days 4, 7, and 14. C. difficile was detected in 23.0% of patients who received a cephalosporin (cefoxitin, 8.3%; cefazolin, 14.3%; cefotetan, 20.0%; ceftriaxone, 25.0%; cefoperazone, 43.7%), in 3.3% of patients given mezlocillin, and in none of 15 control volunteers given no antimicrobial agent. No patient experienced diarrhea.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (610K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Aronsson B, Möllby R, Nord CE. Diagnosis and epidemiology of Clostridium difficile enterocolitis in Sweden. J Antimicrob Chemother. 1984 Dec;14 (Suppl 500):85–95. [PubMed]
  • Aronsson B, Möllby R, Nord CE. Antimicrobial agents and Clostridium difficile in acute enteric disease: epidemiological data from Sweden, 1980-1982. J Infect Dis. 1985 Mar;151(3):476–481. [PubMed]
  • Arsura EL, Fazio RA, Wickremesinghe PC. Pseudomembranous colitis following prophylactic antibiotic use in primary cesarean section. Am J Obstet Gynecol. 1985 Jan 1;151(1):87–89. [PubMed]
  • Bartlett JG, Taylor NS, Chang T, Dzink J. Clinical and laboratory observations in Clostridium difficile colitis. Am J Clin Nutr. 1980 Nov;33(11 Suppl):2521–2526. [PubMed]
  • Bender BS, Bennett R, Laughon BE, Greenough WB, 3rd, Gaydos C, Sears SD, Forman MS, Bartlett JG. Is Clostridium difficile endemic in chronic-care facilities? Lancet. 1986 Jul 5;2(8497):11–13. [PubMed]
  • Bodey GP, Fainstein V, Garcia I, Rosenbaum B, Wong Y. Effect of broad-spectrum cephalosporins on the microbial flora of recipients. J Infect Dis. 1983 Nov;148(5):892–897. [PubMed]
  • Buchanan AG. Selective enrichment broth culture for detection of Clostridium difficile and associated cytotoxin. J Clin Microbiol. 1984 Jul;20(1):74–76. [PMC free article] [PubMed]
  • Church JM, Fazio VW. A role for colonic stasis in the pathogenesis of disease related to Clostridium difficile. Dis Colon Rectum. 1986 Dec;29(12):804–809. [PubMed]
  • Cumming AD, Thomson BJ, Sharp J, Poxton IR, Fraser A. Diarrhoea due to Clostridium difficile associated with antibiotic treatment in patients receiving dialysis: the role of cross infection. Br Med J (Clin Res Ed) 1986 Jan 25;292(6515):238–239. [PMC free article] [PubMed]
  • de Lalla F, Privitera G, Ortisi G, Rizzardini G, Santoro D, Pagano A, Rinaldi E, Scarpellini P. Third generation cephalosporins as a risk factor for Clostridium difficile-associated disease: a four-year survey in a general hospital. J Antimicrob Chemother. 1989 Apr;23(4):623–631. [PubMed]
  • de Lalla F, Privitera G, Rinaldi E, Ortisi G, Santoro D, Rizzardini G. Treatment of Clostridium difficile-associated disease with teicoplanin. Antimicrob Agents Chemother. 1989 Jul;33(7):1125–1127. [PMC free article] [PubMed]
  • Ellis ME, Mandal BK, Dunbar EM, Bundell KR. Clostridium difficile and its cytotoxin in infants admitted to hospital with infectious gastroenteritis. Br Med J (Clin Res Ed) 1984 Feb 18;288(6416):524–526. [PMC free article] [PubMed]
  • Fekety R, Kim KH, Brown D, Batts DH, Cudmore M, Silva J., Jr Epidemiology of antibiotic-associated colitis; isolation of Clostridium difficile from the hospital environment. Am J Med. 1981 Apr;70(4):906–908. [PubMed]
  • George WL, Rolfe RD, Finegold SM. Clostridium difficile and its cytotoxin in feces of patients with antimicrobial agent-associated diarrhea and miscellaneous conditions. J Clin Microbiol. 1982 Jun;15(6):1049–1053. [PMC free article] [PubMed]
  • Keighley MR, Ambrose NS, Morris DL, Burdon DW. Evaluation of mezlocillin in elective gastrointestinal surgery. J Antimicrob Chemother. 1983 May;11 (Suppl 100):65–69. [PubMed]
  • Kim KH, Fekety R, Batts DH, Brown D, Cudmore M, Silva J, Jr, Waters D. Isolation of Clostridium difficile from the environment and contacts of patients with antibiotic-associated colitis. J Infect Dis. 1981 Jan;143(1):42–50. [PubMed]
  • Malamou-Ladas H, O'Farrell S, Nash JQ, Tabaqchali S. Isolation of Clostridium difficile from patients and the environment of hospital wards. J Clin Pathol. 1983 Jan;36(1):88–92. [PMC free article] [PubMed]
  • McFarland LV, Mulligan ME, Kwok RY, Stamm WE. Nosocomial acquisition of Clostridium difficile infection. N Engl J Med. 1989 Jan 26;320(4):204–210. [PubMed]
  • Mulligan ME, George WL, Rolfe RD, Finegold SM. Epidemiological aspects of Clostridium difficile-induced diarrhea and colitis. Am J Clin Nutr. 1980 Nov;33(11 Suppl):2533–2538. [PubMed]
  • Nakamura S, Nakashio S, Inamatsu T, Nishida N, Taniguchi N, Nishida S. Toxigenicity of Clostridium difficile isolates from patients and healthy adults. Microbiol Immunol. 1980;24(10):995–997. [PubMed]
  • Roberts AP, Hughes AW. Complications with antibiotics used prophylactically in joint replacement surgery: a case report of cephradine-induced pseudomembranous colitis. Int Orthop. 1985;8(4):299–302. [PubMed]
  • Savage AM, Alford RH. Nosocomial spread of Clostridium difficile. Infect Control. 1983 Jan-Feb;4(1):31–33. [PubMed]
  • Talbot RW, Walker RC, Beart RW., Jr Changing epidemiology, diagnosis, and treatment of Clostridium difficile toxin-associated colitis. Br J Surg. 1986 Jun;73(6):457–460. [PubMed]
  • Tan J, Bayne LH, McLeod PJ. Pseudomembranous colitis. A fatal case following prophylactic cephaloridine therapy. JAMA. 1979 Aug 24;242(8):749–750. [PubMed]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)