Ever since the invention of penicillin in the mid-20th century, there has been much talk about the harmful effects of antibiotics on the body. The indications for the use of antibiotics are variable and depend on the site of infection, the pathogenic pathogen as well as the general condition, and the clinical state of the patient. Unfortunately, antibiotics not only affect pathogenic bacteria, but also bacteria belonging to the natural physiological flora, leading to their elimination and often to the complete sterilisation of areas where they should physiologically be present.
The role of saprophytic (beneficial) bacteria in the body is invaluable: they are involved in the regulation of digestive processes, electrolyte absorption, maintain an appropriate pH in the vagina and intestine, and are a necessary component of the protective barrier of the immune system.
Under the influence of antibiotic therapy, however, this dynamic "microbiological" balance is very often upset. Beneficial bacterial strains such as Lactobacillus and Bifidobacterium are replaced by pathogenic bacteria with adverse effects, such as Clostridium difficile, which produces toxins A and B and is the main cause of persistent post-antibiotic diarrhoea.
Occasionally, there are other strains: Enterococcus genus , Clostridium perfringens type A, Klebsiella oxytoca and others, as well as fungi - mainly from the Candida family. An imbalance in the intestinal microflora makes the body more susceptible to foodborne infections caused by Salmonella, E.coli or Listeria. Long-term imbalances in the intestinal microflora contribute to an increased risk of colorectal cancer and inflammatory bowel disease, such as ulcerative colitis.
However, the most common symptom of a disturbed gut microflora is diarrhoea. The prevalence of antibiotic-associated diarrhoea in adults is estimated to be between 5 and 30 per cent, including approximately 20 per cent in patients treated in hospital. In children, on the other hand, it ranges from 11 even up to 40%, with a prevalence below 2 years of age.
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In addition to young age, a factor favouring the occurrence of post-antibiotic diarrhoea is the type of antibiotic used. While it is true that any antibiotic can cause diarrhoea, broad-spectrum antibacterial preparations that are active against anaerobic bacteria - aminopenicillins, aminopenicillin with clavulanic acid, some cephalosporins and clindamycin - pose the greatest risk.
