Clindamycin associated colitis

Protracted diarrheal illness has been observed in three patients coincident with oral administration of clindamycin in standard doses. These patients were not known to have preexisting intestinal disease and no other cause of the diarrheal illnesses was found. Diarrhea was experienced after taking oral clindamycin from 3 to 10 days. Associated symptoms included abdominal pain, low grade fever, and occasional hematochezia. At sigmoidoscopic examination the mucosa was friable or edematous, or both, and associated with unusual yellowish white plaques. Lesions cleared and symptoms resolved within 4 to 6 weeks and have not recurred. These cases, along with three others reported, support the probability that clindamycin can induce proctocolitis. Awareness of this condition should help differentiate this reversible form of inflammatory bowel disease from chronic ulcerative colitis.