Major destruction of normal flora of gut, due to long broad spectrum medication
- Clostridium highest resistance, ---- vancomycin and metrandizole
- amxocillin in children, results in superinfection in neck/mouth/thrush
Superinfection Colonization with commensal organisms can be beneficial, given that they compete with and crowd out more pathogenic organisms. They may even have a role in the prevention of other human diseases and in proper immune system development.
Administration of antimicrobials usually alter bacterial flora but with no ill effect in most cases however, broad-spectrum antibiotics if used for long time may alter or kill bacterial flora. So, the bacteria and fungi that are normally inhibited by bacterial flora will multiply leading to superinfection (its early manifestation may by diarrhea).
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Causative micro-organisms : may be staphylococci, Pseudomonas, proteus, Candida albicans or Clostridia difficile.
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sites: Superinfection may be vaginal, oral, pharyngeal or even systemic infection e.g. staphylococcal enterocolitis, candidiasis or Pseudomembranous colitis(=antibiotic-associated diarrhea).
For example: 1-Administration of antibiotics can lead to the overgrowth of the gastrointestinal (GI) pathogen Clostridioides difficile, which is clinically resistant to most antibiotics. C difficile can cause diarrhea and life-threatening bowel inflammation.
2- Similarly, administration of broad-spectrum antibacterial drugs can select for the overgrowth of fungi, most commonly yeasts of the genus Candida. Disseminated Candida infections carry a high risk of death.
To reduce the risk of the impact of antibiotics on the commensal flora, and thus the likelihood of superinfection, antibiotics should be administered only to patients with proven or probable infections, using the most narrow-spectrum agents appropriate to the infection for the shortest effective duration.
Treatment:
- Stop the causative agent and give drug, which kill the organisms responsible for super infection e.g.
(staphylococcal enterocolitis, which is treated by metronidazole or vancomycin orally), antifungal nystatin for candidiasis. If it is in the form of pseudmembranous colitis, it is treated with (antianaerobic e.g. metronidazole or vancomycin, in addition you must give symptomatic treatment in form of adsorbants and antidiarrheal).