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Treatments and drugs
By Mayo Clinic staff
Mild diarrhea
If you have mild diarrhea, your symptoms are likely to clear up within a few days to two weeks after your antibiotic treatment ends. In the meantime, your doctor may recommend drinking plenty of liquids to prevent dehydration and avoiding foods that may aggravate your symptoms. When diarrhea is more severe, your doctor may stop your antibiotic therapy and wait for your diarrhea to subside.
Severe diarrhea
In cases of very severe diarrhea, colitis or pseudomembranous colitis, you're likely to be treated with the drug metronidazole (Flagyl), which is usually taken in tablet form for 10 days. If metronidazole isn't effective, or you're pregnant or breast-feeding, you'll receive another drug, vancomycin (Vancocin).
Both metronidazole and vancomycin are antibiotics that effectively control C. difficile. Vancomycin was once the drug of choice for treating antibiotic-associated diarrhea, but it's very expensive and now usually reserved for the most resistant cases. However, vancomycin is recommended for pregnant and lactating women because metronidazole has not been proved safe in fetuses and infants.
Some people treated for pseudomembranous colitis have a recurrence of diarrhea and need further treatment.
Probiotics: More research needed
The term "probiotic" means "for life." It generally refers to concentrated supplements of beneficial bacteria similar to those that occur naturally in your intestinal tract. Most probiotic supplements are formulated to survive the digestive process and the highly acidic conditions in your stomach.
Probiotic supplements may help prevent antibiotic-associated diarrhea, but study results have been mixed. Some studies have shown probiotic supplements to be effective in preventing or reducing antibiotic-associated diarrhea, while others have not. More research is needed before probiotics can be routinely recommended for antibiotic-associated diarrhea.
Probiotic formulas are available in liquid and capsule form in drugstores and natural food stores and in some grocery stores. Many need refrigeration. In addition, commercial yogurt labeled as having live cultures contains certain "good" bacteria, such as Lactobacillus acidophilus, that may help reduce the incidence and severity of antibiotic-associated diarrhea.
Another probiotic, the yeast Saccharomyces boulardii, has been shown to help protect against pseudomembranous colitis. This yeast, taken orally, is used in Europe to help prevent antibiotic-associated diarrhea and may also prevent recurrences of the disease.
Capsules of S. boulardii are available in the dietary supplement Florastor, in natural food stores and some drugstores. Although S. boulardii rarely causes side effects, avoid it if you have a yeast allergy. And if you have HIV/AIDS, talk to your doctor before trying this product.
