Can antibiotics cause diarrhea? And what should I do about it?

Yes, antibiotics can cause diarrhea as a common side effect, ranging from mild issues to severe health conditions [4]. When taking these medications, you may be exposed to unwanted side effects, so it is always recommended to contact your healthcare provider or attending physician immediately upon the appearance of any side effects such as diarrhea, whether in you or your child, to receive appropriate medical guidance for your individual case [4].

Why do antibiotics cause diarrhea?

Antibiotics are powerful medications crucial for preventing and treating bacterial infections, as they work by killing bacteria or stopping their growth [3]. However, Clostridioides difficile (C. diff) is a type of bacterium that usually lives harmlessly in the gut alongside many other bacterial species. When you take antibiotics, the balance of bacteria in the gut can be disrupted, causing an active infection [5].

C. diff infection can cause diarrhea that leads to severe damage to the colon, and in some cases, it can be life-threatening [1]. This infection spreads very easily between people if the bacteria in the infected person's stool reach surrounding surfaces and objects [5].

What are the symptoms and signs that require urgent consultation?

Common symptoms associated with C. diff infection include diarrhea, high body temperature, loss of appetite, nausea, and stomach pain [5]. Factors that may increase the risk of this infection include being over 65 years old, long-term stays in a hospital or care facility, a weakened immune system due to conditions like diabetes or kidney failure, or taking medications that reduce stomach acid [5].

You should request an urgent appointment with a doctor if you are experiencing diarrhea while taking or having recently taken antibiotics, if you have bloody diarrhea or rectal bleeding, or if your diarrhea lasts for more than seven consecutive days [5].

How to manage antibiotic-associated diarrhea

If the doctor suspects you have a C. diff infection, they may request a stool sample for medical testing [5]. This type of infection is usually treated by stopping any antibiotics you are currently taking, if possible, and starting a new 10-day course of a different type of antibiotic specifically intended to treat this infection [5].

To avoid dehydration from persistent diarrhea, you will be directed to drink plenty of water [5]. It is crucial to avoid taking medications that stop diarrhea, such as loperamide, as they may prevent your body from clearing the bacterial infection and cleansing the intestinal tract [5].

If you are prescribed medication to treat this infection, you must continue taking the prescribed antibiotics until you finish all tablets, capsules, or liquid medication, even if you feel better early on; stopping treatment early may lead to the return of symptoms and worsening of the condition [5].

Additional tips for safe use and prevention

Taking antibiotics only when you need them is an important way to protect yourself and combat antimicrobial resistance [3]. Do not take these medications to treat viral infections like the common cold, a runny nose, or the flu, as they will not make you feel better and may expose you to harmful side effects without any medical benefit [4]. To learn more about proper use, see the article Antibiotics: When Are They Necessary and How to Use Them Effectively and Safely (Arabic).

To prevent the spread of C. diff to others, stay home until at least 48 hours have passed since the diarrhea stopped, and wash your hands regularly with soap and water. Remember that alcohol-based hand sanitizers do not kill or remove these bacteria, so traditional hand washing is the best and safest option to protect those around you [5].

Medical references

• Antibiotics
• Antibiotic Use and Antimicrobial Resistance Facts
• Healthy Habits: Antibiotic Do's and Don'ts | Antibiotic Prescribing and Use | CDC
• Clostridioides difficile (C. diff) - NHS